Provider Demographics
NPI:1417541665
Name:PENRY CHIROPRACTIC PS
Entity Type:Organization
Organization Name:PENRY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-889-4701
Mailing Address - Street 1:10512 NE 68TH ST STE C102
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7002
Mailing Address - Country:US
Mailing Address - Phone:425-889-4701
Mailing Address - Fax:425-889-4702
Practice Address - Street 1:10512 NE 68TH ST STE C102
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7002
Practice Address - Country:US
Practice Address - Phone:425-889-4701
Practice Address - Fax:425-889-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty