Provider Demographics
NPI:1104013143
Name:ANDREW D WINN DC PLLC
Entity Type:Organization
Organization Name:ANDREW D WINN DC PLLC
Other - Org Name:ATLAS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-527-1030
Mailing Address - Street 1:2228 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4142
Mailing Address - Country:US
Mailing Address - Phone:360-527-1030
Mailing Address - Fax:360-734-1690
Practice Address - Street 1:2228 JAMES ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4142
Practice Address - Country:US
Practice Address - Phone:360-527-1030
Practice Address - Fax:360-734-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV11386Medicare UPIN