Provider Demographics
NPI:1154630069
Name:SIMPSON, DEREK (DC, ND)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HIGHWAY 603
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-9064
Mailing Address - Country:US
Mailing Address - Phone:815-507-6208
Mailing Address - Fax:360-338-3742
Practice Address - Street 1:6009 CAPITOL BLVD SW STE 103C
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-5295
Practice Address - Country:US
Practice Address - Phone:360-338-3735
Practice Address - Fax:360-338-3742
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60736006175F00000X
WACHIR.CH.60836756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No175F00000XOther Service ProvidersNaturopath