Provider Demographics
NPI:1184827800
Name:KIRKLAND LIFE CHIROPRACTIC, P.S.
Entity Type:Organization
Organization Name:KIRKLAND LIFE CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-576-5433
Mailing Address - Street 1:13116 NE 70TH PL
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8571
Mailing Address - Country:US
Mailing Address - Phone:425-576-5433
Mailing Address - Fax:425-803-5044
Practice Address - Street 1:13116 NE 70TH PL
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8571
Practice Address - Country:US
Practice Address - Phone:425-576-5433
Practice Address - Fax:425-803-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADC3653111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty