Provider Demographics
NPI:1033172341
Name:BOURREE, DAVID PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:BOURREE
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 1:12841 NE 85TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8009
Mailing Address - Country:US
Mailing Address - Phone:425-827-0334
Mailing Address - Fax:425-893-8046
Practice Address - Street 1:12841 NE 85TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8009
Practice Address - Country:US
Practice Address - Phone:425-827-0334
Practice Address - Fax:425-893-8046
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB34244Medicare PIN
WAU24511Medicare UPIN