Provider Demographics
NPI:1376620997
Name:SAMMAMISH CHIROPRACTIC, PS
Entity Type:Organization
Organization Name:SAMMAMISH CHIROPRACTIC, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-391-2380
Mailing Address - Street 1:660 NW GILMAN BLVD STE C4
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2421
Mailing Address - Country:US
Mailing Address - Phone:425-391-2380
Mailing Address - Fax:425-391-2381
Practice Address - Street 1:660 NW GILMAN BLVD
Practice Address - Street 2:SUITE #C4
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2421
Practice Address - Country:US
Practice Address - Phone:425-391-2380
Practice Address - Fax:425-391-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOOO3358111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB26772Medicare ID - Type Unspecified
WAU65152Medicare UPIN