Provider Demographics
NPI:1174850150
Name:JAS WALIA CHIROPRACTIC, INC PS
Entity Type:Organization
Organization Name:JAS WALIA CHIROPRACTIC, INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-782-9762
Mailing Address - Street 1:905 NE 45TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4783
Mailing Address - Country:US
Mailing Address - Phone:206-782-9762
Mailing Address - Fax:
Practice Address - Street 1:905 NE 45TH ST
Practice Address - Street 2:STE B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4783
Practice Address - Country:US
Practice Address - Phone:206-782-9762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty