Provider Demographics
NPI:1154443638
Name:CALHOUN, ROBERT D (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:CALHOUN
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 1:1210 N 45TH ST
Mailing Address - Street 2:WALLINGFORD CHIROPRACTIC CLINIC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6668
Mailing Address - Country:US
Mailing Address - Phone:206-633-1806
Mailing Address - Fax:
Practice Address - Street 1:1210 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6668
Practice Address - Country:US
Practice Address - Phone:206-633-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2108108Medicaid
WA000100745Medicare ID - Type Unspecified