Provider Demographics
NPI:1033341128
Name:CONTEMPORARY CHIROPRACTIC PS
Entity Type:Organization
Organization Name:CONTEMPORARY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-901-8800
Mailing Address - Street 1:12503 SE MILL PLAIN BLVD
Mailing Address - Street 2:SUITE 215A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4009
Mailing Address - Country:US
Mailing Address - Phone:360-448-6353
Mailing Address - Fax:240-371-7188
Practice Address - Street 1:12503 SE MILL PLAIN BLVD
Practice Address - Street 2:SUITE 215A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-4009
Practice Address - Country:US
Practice Address - Phone:360-448-6353
Practice Address - Fax:240-371-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-22
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty