Provider Demographics
NPI:1437235520
Name:LUXON, LANE M (DC)
Entity Type:Individual
Prefix:DR
First Name:LANE
Middle Name:M
Last Name:LUXON
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-0388
Mailing Address - Country:US
Mailing Address - Phone:360-318-0123
Mailing Address - Fax:360-318-0424
Practice Address - Street 1:105 5TH ST
Practice Address - Street 2:#205
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1966
Practice Address - Country:US
Practice Address - Phone:360-318-0123
Practice Address - Fax:360-318-0424
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002166111N00000X
CA17996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA117269OtherLABOR & INDUSTRIES