Provider Demographics
NPI:1104009372
Name:WINSLOW CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:WINSLOW CHIROPRACTIC CENTER, LLC
Other - Org Name:SOUND LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WINSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-820-2101
Mailing Address - Street 1:11930 SLATER AVENUE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-820-2101
Mailing Address - Fax:425-820-2105
Practice Address - Street 1:11930 SLATER AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4175
Practice Address - Country:US
Practice Address - Phone:425-820-2101
Practice Address - Fax:425-820-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty