Provider Demographics
NPI:1043403710
Name:TUTTLE CHIROPRACTIC CENTER PS
Entity Type:Organization
Organization Name:TUTTLE CHIROPRACTIC CENTER PS
Other - Org Name:TUTTLE CHIROPRACTIC CENTER, P.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-467-8611
Mailing Address - Street 1:1205 2ND AVE # 120
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2950
Mailing Address - Country:US
Mailing Address - Phone:206-467-8611
Mailing Address - Fax:206-467-6337
Practice Address - Street 1:1205 2ND AVE # 120
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2950
Practice Address - Country:US
Practice Address - Phone:206-467-8611
Practice Address - Fax:206-467-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1326183872OtherINDIVIDUAL NPI
WA1326183872OtherINDIVIDUAL NPI