Provider Demographics
NPI:1508911447
Name:ZOGRAFOS, GREGORY CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:CARL
Last Name:ZOGRAFOS
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 1:626 128TH ST SW
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6368
Mailing Address - Country:US
Mailing Address - Phone:425-513-1880
Mailing Address - Fax:425-513-6161
Practice Address - Street 1:626 128TH ST SW
Practice Address - Street 2:SUITE 103B
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6368
Practice Address - Country:US
Practice Address - Phone:425-513-1880
Practice Address - Fax:425-513-6161
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1729111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA408006001OtherGROUP HEALTH
WAR76533OtherREGENCE
WA0179721OtherLABOR AND INDUSTRIES
WA58732OtherLABOR & INDUSTRIES
WAR76533OtherREGENCE
WAT02416Medicare UPIN