Provider Demographics
NPI:1043235807
Name:RAINIER VALLEY CHIROPRACTIC PS
Entity Type:Organization
Organization Name:RAINIER VALLEY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-723-2820
Mailing Address - Street 1:4236 36TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1312
Mailing Address - Country:US
Mailing Address - Phone:206-723-2820
Mailing Address - Fax:206-722-3664
Practice Address - Street 1:4236 36TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1312
Practice Address - Country:US
Practice Address - Phone:206-723-2820
Practice Address - Fax:206-722-3664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000980111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB15879Medicare ID - Type UnspecifiedGROUP NUMBER