Provider Demographics
NPI:1043432958
Name:GEMMER, ERWIN (DC)
Entity Type:Individual
Prefix:
First Name:ERWIN
Middle Name:
Last Name:GEMMER
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 1:9414 RIDGETOP BLVD
Mailing Address - Street 2:101
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-308-0250
Mailing Address - Fax:
Practice Address - Street 1:9414 RIDGETOP BLVD
Practice Address - Street 2:101
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383
Practice Address - Country:US
Practice Address - Phone:360-308-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8851933Medicare ID - Type UnspecifiedPART B PROVIDER