Provider Demographics
NPI:1053653238
Name:JUERGENS CHIROPRACTIC , LLC
Entity Type:Organization
Organization Name:JUERGENS CHIROPRACTIC , LLC
Other - Org Name:CHRIS JUERGENS DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JUERGENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-943-4797
Mailing Address - Street 1:100 RUBY ST SE STE F
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6724
Mailing Address - Country:US
Mailing Address - Phone:360-943-4797
Mailing Address - Fax:360-709-0542
Practice Address - Street 1:100 RUBY ST SE STE F
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:360-943-4797
Practice Address - Fax:360-709-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034772111N00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty