Provider Demographics
NPI:1437641511
Name:HYBRID HEALTH PLLC
Entity Type:Organization
Organization Name:HYBRID HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MELIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-764-0753
Mailing Address - Street 1:5414 NE 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2165
Mailing Address - Country:US
Mailing Address - Phone:360-271-3070
Mailing Address - Fax:
Practice Address - Street 1:1703 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2607
Practice Address - Country:US
Practice Address - Phone:360-764-0753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty