Provider Demographics
NPI:1326082017
Name:GAUTHUN, DAVID EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EUGENE
Last Name:GAUTHUN
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:PO BOX 2401
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-2401
Mailing Address - Country:US
Mailing Address - Phone:360-681-4322
Mailing Address - Fax:360-683-5569
Practice Address - Street 1:20 LEE CHATFIELD AVE.
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3593
Practice Address - Country:US
Practice Address - Phone:360-681-4322
Practice Address - Fax:360-683-5569
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA37037OtherLABOR & INDUSTRIES
WAU47147Medicare UPIN
WA37037OtherLABOR & INDUSTRIES
WAG8869714Medicare PIN