Provider Demographics
NPI:1013044908
Name:MILLS, CHAD N (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:N
Last Name:MILLS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HAM RD
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-5202
Mailing Address - Country:US
Mailing Address - Phone:360-330-1312
Mailing Address - Fax:360-330-1320
Practice Address - Street 1:1102 KRESKY AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3732
Practice Address - Country:US
Practice Address - Phone:360-330-1312
Practice Address - Fax:360-330-1320
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8869913OtherCHAD PTAN
WA8903893OtherL&I CRIME
WA0165764OtherL& I GROUP
WADB2803OtherMEDICARE RAILROAD GROUP
WA8349730Medicaid
WA0165765OtherL&I CHAD MILLS DC
WA8869221OtherMMC PTAN
WAP00096548OtherMEDICARE RAILROAD