Provider Demographics
NPI:1497704308
Name:BANKER, ERIC LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LEE
Last Name:BANKER
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 1:1200 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-7519
Mailing Address - Country:US
Mailing Address - Phone:509-665-8201
Mailing Address - Fax:509-662-9104
Practice Address - Street 1:630 N CHELAN AVE
Practice Address - Street 2:SUITE A-3
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6622
Practice Address - Country:US
Practice Address - Phone:509-663-5101
Practice Address - Fax:509-662-9104
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA179405OtherSTATE L & I NUMBER
WAU98858Medicare UPIN
WA179405OtherSTATE L & I NUMBER