Provider Demographics
NPI:1083983753
Name:CRAIG M BURNS LLC
Entity Type:Organization
Organization Name:CRAIG M BURNS LLC
Other - Org Name:REDMOND SPORTS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-233-9059
Mailing Address - Street 1:15655 NE 85TH ST
Mailing Address - Street 2:STE 3
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3563
Mailing Address - Country:US
Mailing Address - Phone:425-881-3100
Mailing Address - Fax:425-881-3102
Practice Address - Street 1:15655 NE 85TH STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3563
Practice Address - Country:US
Practice Address - Phone:425-881-3100
Practice Address - Fax:425-881-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty