Provider Demographics
NPI:1477576213
Name:KURTZ, JAMES THEODORE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THEODORE
Last Name:KURTZ
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 1:33400 13TH PL S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6357
Mailing Address - Country:US
Mailing Address - Phone:253-838-6070
Mailing Address - Fax:253-838-6069
Practice Address - Street 1:33400 13TH PL S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6357
Practice Address - Country:US
Practice Address - Phone:253-838-6070
Practice Address - Fax:253-838-6069
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAKU7041OtherREGENCE
WA111632OtherDEPT OF L & I
WAKU7041OtherREGENCE