Provider Demographics
NPI:1366658890
Name:WAY OF LIFE CHIROPRACTIC PS
Entity Type:Organization
Organization Name:WAY OF LIFE CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PENELOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-313-0433
Mailing Address - Street 1:355 NW GILMAN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2401
Mailing Address - Country:US
Mailing Address - Phone:425-313-0433
Mailing Address - Fax:425-313-5069
Practice Address - Street 1:355 NW GILMAN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2401
Practice Address - Country:US
Practice Address - Phone:425-313-0433
Practice Address - Fax:425-313-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA217141600Medicare ID - Type Unspecified