1639172646 NPI number — MR. TIMOTHY B PRICE DC

Table of content: MR. TIMOTHY B PRICE DC (NPI 1639172646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639172646 NPI number — MR. TIMOTHY B PRICE DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRICE
Provider First Name:
TIMOTHY
Provider Middle Name:
B
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639172646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 EAST 29TH AVE.
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-455-7552
Provider Business Mailing Address Fax Number:
509-747-6130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 EAST 29TH AVE.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-7552
Provider Business Practice Location Address Fax Number:
509-747-6130
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH00034209 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 602288498 . This is a "UNIFIED BUSINESS ID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: CH00034209 . This is a "CHIROPRACTIC LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com