Provider Demographics
NPI:1467662213
Name:BACK IN ACTION, INC.
Entity Type:Organization
Organization Name:BACK IN ACTION, INC.
Other - Org Name:BACK IN ACTION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ESCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-635-0495
Mailing Address - Street 1:1940 116TH AVE NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3097
Mailing Address - Country:US
Mailing Address - Phone:425-635-0495
Mailing Address - Fax:425-635-0492
Practice Address - Street 1:1940 116TH AVE NE
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3097
Practice Address - Country:US
Practice Address - Phone:425-635-0495
Practice Address - Fax:425-635-0492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAES3571Medicare UPIN