Provider Demographics
NPI:1306206701
Name:STEWART, JEREMY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:STEWART
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 1:14100 SE 36TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1675
Mailing Address - Country:US
Mailing Address - Phone:425-614-0680
Mailing Address - Fax:425-614-0679
Practice Address - Street 1:14100 SE 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1675
Practice Address - Country:US
Practice Address - Phone:425-614-0680
Practice Address - Fax:425-614-0679
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60551537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor