Provider Demographics
NPI:1326094087
Name:WARD, TODD ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:ALLEN
Last Name:WARD
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 1:7904 NE 6TH AVE
Mailing Address - Street 2:STE C
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665
Mailing Address - Country:US
Mailing Address - Phone:360-885-1975
Mailing Address - Fax:360-253-9376
Practice Address - Street 1:7904 NE 6TH AVE
Practice Address - Street 2:STE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665
Practice Address - Country:US
Practice Address - Phone:360-885-1975
Practice Address - Fax:360-253-9376
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25634Medicare UPIN