Provider Demographics
NPI:1417080375
Name:FRICKE, HAROLD HENRY JR (DC)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:HENRY
Last Name:FRICKE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:HAROLD
Other - Middle Name:H
Other - Last Name:FRICKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:211 WEST HILL STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1404
Mailing Address - Country:US
Mailing Address - Phone:360-794-6620
Mailing Address - Fax:360-794-9863
Practice Address - Street 1:211 WEST HILL STREET
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1404
Practice Address - Country:US
Practice Address - Phone:360-794-6620
Practice Address - Fax:360-794-9863
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor