Provider Demographics
NPI:1194861070
Name:VOSS, EDWARD CHARLES (DC)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:CHARLES
Last Name:VOSS
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:PO BOX 988
Mailing Address - Street 2:10107 213TH ST EAST
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-0988
Mailing Address - Country:US
Mailing Address - Phone:253-847-2687
Mailing Address - Fax:253-846-3012
Practice Address - Street 1:10107 213TH ST E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-0988
Practice Address - Country:US
Practice Address - Phone:253-847-2687
Practice Address - Fax:253-846-3012
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0000237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA26528OtherL&I
WA26528OtherLABOR & INDUSTRIES
WA8852711Medicare ID - Type Unspecified
WA26528OtherL&I
T86911Medicare UPIN
WA26528OtherLABOR & INDUSTRIES