Provider Demographics
NPI:1285853192
Name:BABUIN, STEPHEN RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:BABUIN
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 1:1175 NW GILMAN BLVD STE B5
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5375
Mailing Address - Country:US
Mailing Address - Phone:425-313-8950
Mailing Address - Fax:425-313-9491
Practice Address - Street 1:1175 NW GILMAN BLVD STE B5
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5375
Practice Address - Country:US
Practice Address - Phone:425-313-8950
Practice Address - Fax:425-313-9491
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0003637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB37989Medicare PIN
WAU87888Medicare UPIN