Provider Demographics
NPI:1508071796
Name:YAKIMA CHIROPRACTIC CENTRES INC, P.S.
Entity Type:Organization
Organization Name:YAKIMA CHIROPRACTIC CENTRES INC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WARNINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-248-5555
Mailing Address - Street 1:2508 W NOB HILL
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-5104
Mailing Address - Country:US
Mailing Address - Phone:509-248-5555
Mailing Address - Fax:509-469-4938
Practice Address - Street 1:2508 W NOB HILL
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-5104
Practice Address - Country:US
Practice Address - Phone:509-248-5555
Practice Address - Fax:509-469-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB36079Medicare PIN