Provider Demographics
NPI:1437196565
Name:MCGRAW, MICHAEL REAL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:REAL
Last Name:MCGRAW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 329
Mailing Address - Street 2:355 LINHART AVE. NE
Mailing Address - City:NAPAVINE
Mailing Address - State:WA
Mailing Address - Zip Code:98565
Mailing Address - Country:US
Mailing Address - Phone:360-266-8800
Mailing Address - Fax:360-266-8700
Practice Address - Street 1:355 LINHART AVE.
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98565-0329
Practice Address - Country:US
Practice Address - Phone:360-266-8800
Practice Address - Fax:360-266-8700
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU84916Medicare UPIN
WA8800093Medicare ID - Type Unspecified
WAG8860333Medicare UPIN