Provider Demographics
NPI:1083891394
Name:STEPHEN J ZOGRAFOS DC INC PS
Entity Type:Organization
Organization Name:STEPHEN J ZOGRAFOS DC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZOGRAFOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-850-8163
Mailing Address - Street 1:24909 104TH AVE SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-2819
Mailing Address - Country:US
Mailing Address - Phone:253-850-8163
Mailing Address - Fax:253-850-8164
Practice Address - Street 1:24909 104TH AVE SE
Practice Address - Street 2:SUITE 103
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2819
Practice Address - Country:US
Practice Address - Phone:253-850-8163
Practice Address - Fax:253-850-8164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2315111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty