Provider Demographics
NPI:1235140294
Name:MURRY, THERESA B (DC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:B
Last Name:MURRY
Suffix:
Gender:F
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 1215
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-1215
Mailing Address - Country:US
Mailing Address - Phone:360-734-9525
Mailing Address - Fax:360-734-9505
Practice Address - Street 1:412 GIRARD ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4004
Practice Address - Country:US
Practice Address - Phone:360-734-9525
Practice Address - Fax:360-734-9505
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8866666Medicare PIN
WAG8866667Medicare PIN