Provider Demographics
NPI:1407035785
Name:STEVE OLYNYK DBA RENTON CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:STEVE OLYNYK DBA RENTON CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:OLYNYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-228-2824
Mailing Address - Street 1:108 FACTORY AVE N
Mailing Address - Street 2:STE 2A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5727
Mailing Address - Country:US
Mailing Address - Phone:425-228-2824
Mailing Address - Fax:425-228-6956
Practice Address - Street 1:108 FACTORY AVE N
Practice Address - Street 2:STE 2A
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5727
Practice Address - Country:US
Practice Address - Phone:425-228-2824
Practice Address - Fax:425-228-6956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOOO3282111N00000X
WACH00003464111N00000X
WAMA00011739174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA482044Medicare UPIN