Provider Demographics
NPI:1003314857
Name:FREEDOM INITIATIVE, LLC
Entity Type:Organization
Organization Name:FREEDOM INITIATIVE, LLC
Other - Org Name:FREEDOM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-427-0276
Mailing Address - Street 1:1818 WESTLAKE AVE N STE 216
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2707
Mailing Address - Country:US
Mailing Address - Phone:206-427-0276
Mailing Address - Fax:
Practice Address - Street 1:1818 WESTLAKE AVE N STE 216
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2707
Practice Address - Country:US
Practice Address - Phone:206-427-0276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH603417312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty