Provider Demographics
NPI:1316009269
Name:BENTZ, JAMES D (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:BENTZ
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 1:316 O AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-1542
Mailing Address - Country:US
Mailing Address - Phone:360-588-9108
Mailing Address - Fax:360-588-0258
Practice Address - Street 1:316 O AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-1542
Practice Address - Country:US
Practice Address - Phone:360-588-9108
Practice Address - Fax:360-588-0258
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB08697Medicare ID - Type Unspecified