Provider Demographics
NPI:1497869838
Name:DAHLINGER, RODNEY J (DC)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:J
Last Name:DAHLINGER
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 1:18209 149TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1105
Mailing Address - Country:US
Mailing Address - Phone:360-794-0945
Mailing Address - Fax:
Practice Address - Street 1:14815 CHAIN LAKE RD STE J
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-8775
Practice Address - Country:US
Practice Address - Phone:360-794-3376
Practice Address - Fax:360-794-6203
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB34326Medicare ID - Type UnspecifiedGROUP #