Provider Demographics
NPI:1235553058
Name:PHANEUF, ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:PHANEUF
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 1:909 SQUALICUM WAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2077
Mailing Address - Country:US
Mailing Address - Phone:360-739-5679
Mailing Address - Fax:
Practice Address - Street 1:909 SQUALICUM WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2077
Practice Address - Country:US
Practice Address - Phone:360-739-5679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60445584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor