Provider Demographics
NPI:1477698553
Name:LYNNWOOD FAMILY CHIROPRACTIC PS
Entity Type:Organization
Organization Name:LYNNWOOD FAMILY CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-743-9460
Mailing Address - Street 1:16303 HIGHWAY 99
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-1453
Mailing Address - Country:US
Mailing Address - Phone:425-743-9460
Mailing Address - Fax:425-367-4404
Practice Address - Street 1:16303 HIGHWAY 99
Practice Address - Street 2:SUITE 1B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-1453
Practice Address - Country:US
Practice Address - Phone:425-743-9460
Practice Address - Fax:425-367-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty