Provider Demographics
NPI:1316044407
Name:BRIDGEMAN, DAVID B (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
Last Name:BRIDGEMAN
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 1:2211 W DOLARWAY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8227
Mailing Address - Country:US
Mailing Address - Phone:509-925-7246
Mailing Address - Fax:509-933-4104
Practice Address - Street 1:2211 W DOLARWAY RD STE 4
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8227
Practice Address - Country:US
Practice Address - Phone:509-925-7246
Practice Address - Fax:509-933-4104
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor