Provider Demographics
NPI:1073787214
Name:C J BARTNESS DC INC PS
Entity Type:Organization
Organization Name:C J BARTNESS DC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARTNESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-636-2470
Mailing Address - Street 1:831 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2403
Mailing Address - Country:US
Mailing Address - Phone:360-636-2470
Mailing Address - Fax:360-636-5009
Practice Address - Street 1:1060 HUDSON ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3103
Practice Address - Country:US
Practice Address - Phone:360-636-2470
Practice Address - Fax:360-636-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT61029Medicare UPIN
WA000700006Medicare PIN