Provider Demographics
NPI:1114371242
Name:CEDAR RIVER CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CEDAR RIVER CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-988-3146
Mailing Address - Street 1:15301 MAPLE VALLEY HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-8128
Mailing Address - Country:US
Mailing Address - Phone:425-988-3146
Mailing Address - Fax:425-988-3151
Practice Address - Street 1:15301 MAPLE VALLEY HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8128
Practice Address - Country:US
Practice Address - Phone:425-988-3146
Practice Address - Fax:425-988-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty