Provider Demographics
NPI:1275577140
Name:NAPAVINE FAMILY CHIROPRACTIC, PS
Entity Type:Organization
Organization Name:NAPAVINE FAMILY CHIROPRACTIC, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAUNI
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:360-266-8800
Mailing Address - Street 1:P.O. BOX 329
Mailing Address - Street 2:355 LINHART AVE.NE
Mailing Address - City:NAPAVINE
Mailing Address - State:WA
Mailing Address - Zip Code:98565
Mailing Address - Country:US
Mailing Address - Phone:360-266-8800
Mailing Address - Fax:360-266-8700
Practice Address - Street 1:355 LINHART AVE. NE
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98565
Practice Address - Country:US
Practice Address - Phone:360-266-8800
Practice Address - Fax:360-266-8700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAPAVINE FAMILY CHIROPRACTIC PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8860333Medicare ID - Type Unspecified