Provider Demographics
NPI:1497868129
Name:LECOVIN, GEOFFREY M (DC, ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:M
Last Name:LECOVIN
Suffix:
Gender:M
Credentials:DC, ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11520 NE 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3005
Mailing Address - Country:US
Mailing Address - Phone:425-999-4484
Mailing Address - Fax:425-999-4484
Practice Address - Street 1:11520 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3005
Practice Address - Country:US
Practice Address - Phone:425-999-4484
Practice Address - Fax:425-999-4484
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2793111N00000X
WA307171100000X
WA778175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath