Provider Demographics
NPI:1073378287
Name:KOWALSKI, BAILEY NICOLE (DC)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:NICOLE
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:NICOLE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8350 W GRANDRIDGE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1678
Mailing Address - Country:US
Mailing Address - Phone:509-737-1400
Mailing Address - Fax:509-737-1406
Practice Address - Street 1:8350 W GRANDRIDGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1678
Practice Address - Country:US
Practice Address - Phone:509-737-1400
Practice Address - Fax:509-737-1400
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61518998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor