Provider Demographics
NPI:1154455376
Name:MICHAEL T ASHLEY DC PC
Entity Type:Organization
Organization Name:MICHAEL T ASHLEY DC PC
Other - Org Name:ASHLEY FAMILY CHIROPRACTIC AND MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-487-0487
Mailing Address - Street 1:18001 BOTHELL EVERETT HWY
Mailing Address - Street 2:STE# 108
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-487-0487
Mailing Address - Fax:425-486-4548
Practice Address - Street 1:18001 BOTHELL EVERETT HWY
Practice Address - Street 2:STE# 108
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012
Practice Address - Country:US
Practice Address - Phone:425-487-0487
Practice Address - Fax:425-486-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA15894OtherWASHINGTON LABOR INDUSTRI
WA105260OtherWA LABOR INDUSTRIES