Provider Demographics
NPI:1376721357
Name:PREMIER CHIROPRACTIC NO. 9 PLLC
Entity Type:Organization
Organization Name:PREMIER CHIROPRACTIC NO. 9 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:URSPRUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-526-9500
Mailing Address - Street 1:9622 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2236
Mailing Address - Country:US
Mailing Address - Phone:206-526-9500
Mailing Address - Fax:206-526-0727
Practice Address - Street 1:9622 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2236
Practice Address - Country:US
Practice Address - Phone:206-526-9500
Practice Address - Fax:206-526-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH34633261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8858594OtherMEDICARE PTAN
1215938055OtherNPI