Provider Demographics
NPI:1225251655
Name:REDMOND SPINAL CARE, P.C.
Entity Type:Organization
Organization Name:REDMOND SPINAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BAGNARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-881-5811
Mailing Address - Street 1:15600 REDMOND WAY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3862
Mailing Address - Country:US
Mailing Address - Phone:425-881-5811
Mailing Address - Fax:425-881-6220
Practice Address - Street 1:15600 REDMOND WAY
Practice Address - Street 2:SUITE 302
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:425-881-5811
Practice Address - Fax:425-881-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0178465OtherLABOR AND INDUSTRIES
WAAB40304Medicare ID - Type Unspecified