Provider Demographics
NPI:1073706693
Name:GRAHAM REHABILITATION AND WELLNESS CENTER INC P S
Entity Type:Organization
Organization Name:GRAHAM REHABILITATION AND WELLNESS CENTER INC P S
Other - Org Name:GRAHAM CHIROPRACTIC CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-310-3534
Mailing Address - Street 1:509 OLIVE WAY STE 620
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1761
Mailing Address - Country:US
Mailing Address - Phone:206-622-9001
Mailing Address - Fax:206-622-4311
Practice Address - Street 1:509 OLIVE WAY STE 620
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1761
Practice Address - Country:US
Practice Address - Phone:206-622-9001
Practice Address - Fax:206-622-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 175F00000X, 225100000X, 225700000X, 111N00000X
WAMA00007872174400000X
WACH00002123111N00000X
WACH60040685111N00000X
WAMA00023264225700000X
WACH2380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty