Provider Demographics
NPI:1346289998
Name:JOSEPH, SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:JOSEPH
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 1:9220 RIDGETOP BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8556
Mailing Address - Country:US
Mailing Address - Phone:360-516-6296
Mailing Address - Fax:360-308-0937
Practice Address - Street 1:9220 RIDGETOP BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8556
Practice Address - Country:US
Practice Address - Phone:360-516-6296
Practice Address - Fax:360-308-0937
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009854111N00000X
WACH60153099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA11503852OtherCAQH
WAG8897141Medicare UPIN
ILK24333Medicare ID - Type Unspecified