Provider Demographics
NPI:1144392135
Name:KLOBY, DEBORAH (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:KLOBY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1544
Mailing Address - Country:US
Mailing Address - Phone:253-376-1093
Mailing Address - Fax:
Practice Address - Street 1:32123 1ST AVE S STE A4
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5720
Practice Address - Country:US
Practice Address - Phone:253-253-3761
Practice Address - Fax:253-874-5024
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT95375Medicare UPIN
WAG217000551Medicare PIN