Provider Demographics
NPI:1497024756
Name:STILLWELL FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:STILLWELL FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:STILLWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-839-2225
Mailing Address - Street 1:27020 PACIFIC HWY S
Mailing Address - Street 2:STE B
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6951
Mailing Address - Country:US
Mailing Address - Phone:253-839-2225
Mailing Address - Fax:253-839-1424
Practice Address - Street 1:27020 PACIFIC HWY S
Practice Address - Street 2:STE B
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-6951
Practice Address - Country:US
Practice Address - Phone:253-839-2225
Practice Address - Fax:253-839-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty