Provider Demographics
NPI:1114077583
Name:STEMP, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STEMP
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 1:7247 S PINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-5900
Mailing Address - Country:US
Mailing Address - Phone:253-473-7518
Mailing Address - Fax:253-474-9596
Practice Address - Street 1:7247 S PINE ST STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5900
Practice Address - Country:US
Practice Address - Phone:253-473-7518
Practice Address - Fax:253-474-9596
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA122159OtherLABOR & INDUSTRIES ID
WAST1111OtherREGENCE PROVIDER ID
WA122159OtherLABOR & INDUSTRIES ID