Provider Demographics
NPI:1114290152
Name:WERNER CHIROPRACTIC PS INC
Entity Type:Organization
Organization Name:WERNER CHIROPRACTIC PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-770-0412
Mailing Address - Street 1:3806 9TH ST SW STE D
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3687
Mailing Address - Country:US
Mailing Address - Phone:253-770-0412
Mailing Address - Fax:253-770-0511
Practice Address - Street 1:3806 9TH ST SW STE D
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3687
Practice Address - Country:US
Practice Address - Phone:253-770-0412
Practice Address - Fax:253-770-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG115001089Medicare PIN