Provider Demographics
NPI:1346685948
Name:OPULENT HEALING INC PS
Entity Type:Organization
Organization Name:OPULENT HEALING INC PS
Other - Org Name:VITALITY SPECIFIC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-297-2792
Mailing Address - Street 1:5211 20TH AVE NW
Mailing Address - Street 2:STE C
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4001
Mailing Address - Country:US
Mailing Address - Phone:206-297-2792
Mailing Address - Fax:206-297-1051
Practice Address - Street 1:1222 E MADISON ST
Practice Address - Street 2:STE D
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3909
Practice Address - Country:US
Practice Address - Phone:206-297-2792
Practice Address - Fax:206-297-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60077573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0247451Medicare PIN