Provider Demographics
NPI:1326024167
Name:MERRY, ROBERT ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERIC
Last Name:MERRY
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 1:3420 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-2101
Mailing Address - Country:US
Mailing Address - Phone:253-272-8694
Mailing Address - Fax:253-272-3035
Practice Address - Street 1:3420 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-2101
Practice Address - Country:US
Practice Address - Phone:253-272-8694
Practice Address - Fax:253-272-3035
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000768111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0012252OtherLABOR & INDUSTRIES
WAME3347OtherREGENCE BLUE SHIELD
WA891614OtherCRIME VICTIMS
WA11730OtherAMERICAN WHOLE HEALTH NET
WA2566008Medicaid
WAME3347OtherREGENCE BLUE SHIELD