Provider Demographics
NPI:1336653757
Name:WOODINVILLE PRIMARY CHIROPRACTIC AND SPA
Entity Type:Organization
Organization Name:WOODINVILLE PRIMARY CHIROPRACTIC AND SPA
Other - Org Name:PERFORMANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-547-4044
Mailing Address - Street 1:14040 NE 181ST ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4373
Mailing Address - Country:US
Mailing Address - Phone:425-483-1777
Mailing Address - Fax:
Practice Address - Street 1:14040 NE 181ST ST STE 1000
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4373
Practice Address - Country:US
Practice Address - Phone:425-483-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VO DC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty