Provider Demographics
NPI:1376266866
Name:LINK CHIROPRACTIC AND WELLNESS PS INC
Entity Type:Organization
Organization Name:LINK CHIROPRACTIC AND WELLNESS PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZARIY
Authorized Official - Middle Name:
Authorized Official - Last Name:STETSYUK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-852-2828
Mailing Address - Street 1:25854 108TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-7737
Mailing Address - Country:US
Mailing Address - Phone:253-852-2828
Mailing Address - Fax:253-852-2830
Practice Address - Street 1:25854 108TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7737
Practice Address - Country:US
Practice Address - Phone:253-852-2828
Practice Address - Fax:253-852-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACHIROPRACTICLICENSEOtherCH61135059
WA0440200OtherLNI
WANPIOther1356933972