Provider Demographics
NPI:1295020725
Name:BOHRNSEN, MICHAEL (DC, DACBSP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BOHRNSEN
Suffix:
Gender:M
Credentials:DC, DACBSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15312 E SPRAGUE AVE
Mailing Address - Street 2:#23
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8861
Mailing Address - Country:US
Mailing Address - Phone:509-795-0277
Mailing Address - Fax:
Practice Address - Street 1:15312 E SPRAGUE AVE
Practice Address - Street 2:#23
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8861
Practice Address - Country:US
Practice Address - Phone:509-795-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32130111N00000X
WACH 60485899111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor