Provider Demographics
NPI:1346539426
Name:LARIMER CHIROPRACTIC AND WELLNESS, PS
Entity Type:Organization
Organization Name:LARIMER CHIROPRACTIC AND WELLNESS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARIMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-334-5051
Mailing Address - Street 1:2100C SE 164TH AVE
Mailing Address - Street 2:#102
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4653
Mailing Address - Country:US
Mailing Address - Phone:360-334-5051
Mailing Address - Fax:360-553-4105
Practice Address - Street 1:2100C SE 164TH AVE
Practice Address - Street 2:#102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4653
Practice Address - Country:US
Practice Address - Phone:360-334-5051
Practice Address - Fax:360-553-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60090162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty