Provider Demographics
NPI:1245237478
Name:ALDER, PAUL DEWANE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DEWANE
Last Name:ALDER
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 1:225 W FRANCIS AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6304
Mailing Address - Country:US
Mailing Address - Phone:509-533-9200
Mailing Address - Fax:509-533-9300
Practice Address - Street 1:225 W FRANCIS AVE
Practice Address - Street 2:STE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6304
Practice Address - Country:US
Practice Address - Phone:509-533-9200
Practice Address - Fax:509-533-9300
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB33971Medicare ID - Type Unspecified
WAU61297Medicare UPIN