Provider Demographics
NPI:1134319650
Name:NASH CHIROPRACTIC PS
Entity Type:Organization
Organization Name:NASH CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-697-5188
Mailing Address - Street 1:23303 HWY 99 STE G
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-8762
Mailing Address - Country:US
Mailing Address - Phone:425-697-5188
Mailing Address - Fax:
Practice Address - Street 1:23303 HWY 99 STE G
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8762
Practice Address - Country:US
Practice Address - Phone:425-697-5188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty