Provider Demographics
NPI:1235337940
Name:PEARSON CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:PEARSON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-638-2424
Mailing Address - Street 1:15610 SE 272ND ST STE A-106
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4416
Mailing Address - Country:US
Mailing Address - Phone:253-638-2424
Mailing Address - Fax:253-639-5115
Practice Address - Street 1:15610 SE 272ND ST STE A-106
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4416
Practice Address - Country:US
Practice Address - Phone:253-638-2424
Practice Address - Fax:253-639-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033967111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU87860Medicare UPIN
WAAB34635Medicare ID - Type Unspecified