Provider Demographics
NPI:1275573693
Name:DARLING, TRISTA L (DC)
Entity Type:Individual
Prefix:MRS
First Name:TRISTA
Middle Name:L
Last Name:DARLING
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 1:327 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2030
Mailing Address - Country:US
Mailing Address - Phone:360-834-5126
Mailing Address - Fax:360-838-1582
Practice Address - Street 1:235 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2033
Practice Address - Country:US
Practice Address - Phone:360-834-5126
Practice Address - Fax:360-834-5126
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA138359OtherKAISER
WA0200616OtherWASHINGTON L&I PROVIDER #
OR885134002OtherREGENCE OF OREGON
WA8434722Medicaid
WA138359OtherKAISER
WAG8856105Medicare ID - Type UnspecifiedPROVIDER NUMBER