| Woodinville Chiropractic, Ps | |
|
17630 140th Ave Ne Ste A Woodinville WA 98072-6876 | |
| (425) 398-3900 | |
| (425) 398-3907 |
| Full Name | Woodinville Chiropractic, Ps |
|---|---|
| Speciality | Clinic/Center |
| Location | 17630 140th Ave Ne, Woodinville, Washington |
| Authorized Official Name and Position | Myron Gudmundson (OWNER) |
| Authorized Official Contact | 4253983900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodinville Chiropractic, Ps 17630 140th Ave Ne Ste A Woodinville WA 98072-6876 Ph: (425) 398-3900 | Woodinville Chiropractic, Ps 17630 140th Ave Ne Ste A Woodinville WA 98072-6876 Ph: (425) 398-3900 |
| NPI Number | 1184049991 |
|---|---|
| Provider Enumeration Date | 03/03/2014 |
| Last Update Date | 03/03/2014 |
| Medicare PECOS PAC ID | 8628394962 |
|---|---|
| Medicare Enrollment ID | O20150305000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184049991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH 60342432 (Washington) | Primary |
| Provider Name | Robert Chant |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760781405 PECOS PAC ID: 5092976472 Enrollment ID: I20140703000944 |
| Provider Name | Myron W Gudmundson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083050496 PECOS PAC ID: 4183940422 Enrollment ID: I20150305000187 |
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