Provider Demographics
NPI:1093806523
Name:POWERS, GEORGE H (DC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:POWERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550
Mailing Address - Country:US
Mailing Address - Phone:360-533-2630
Mailing Address - Fax:360-533-1608
Practice Address - Street 1:2555 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550
Practice Address - Country:US
Practice Address - Phone:360-533-2630
Practice Address - Fax:360-533-1608
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB34008Medicare ID - Type Unspecified