Provider Demographics
NPI:1295814986
Name:POLLARD CHIROPRACTIC P.L.L.C.
Entity Type:Organization
Organization Name:POLLARD CHIROPRACTIC P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CORRIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-638-2424
Mailing Address - Street 1:13003 SE KENT KANGLEY RD
Mailing Address - Street 2:STE 110
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7919
Mailing Address - Country:US
Mailing Address - Phone:253-638-2424
Mailing Address - Fax:253-639-5115
Practice Address - Street 1:13003 SE KENT KANGLEY
Practice Address - Street 2:STE 110
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030
Practice Address - Country:US
Practice Address - Phone:253-638-2424
Practice Address - Fax:253-639-5715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB33661Medicare PIN