Provider Demographics
NPI:1043451743
Name:POND, SKYLAR WINSTON (DC)
Entity Type:Individual
Prefix:
First Name:SKYLAR
Middle Name:WINSTON
Last Name:POND
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 1:400 DEXTER AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4703
Mailing Address - Country:US
Mailing Address - Phone:206-552-5750
Mailing Address - Fax:
Practice Address - Street 1:2324 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2403
Practice Address - Country:US
Practice Address - Phone:206-682-0676
Practice Address - Fax:206-623-0397
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60076566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor