Provider Demographics
NPI:1316224884
Name:WEST BAY CHIROPRACTIC
Entity Type:Organization
Organization Name:WEST BAY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WYATT
Authorized Official - Last Name:BIGGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-683-8111
Mailing Address - Street 1:502 S STILL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3577
Mailing Address - Country:US
Mailing Address - Phone:360-683-8111
Mailing Address - Fax:360-683-9341
Practice Address - Street 1:502 S STILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3577
Practice Address - Country:US
Practice Address - Phone:360-683-8111
Practice Address - Fax:360-683-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 1899261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT02662Medicare UPIN
WAG-001000091Medicare PIN