Provider Demographics
NPI:1518030980
Name:WASSERMAN, MICHAEL CORET (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CORET
Last Name:WASSERMAN
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 1:7439 CORLISS AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4932
Mailing Address - Country:US
Mailing Address - Phone:206-523-0311
Mailing Address - Fax:
Practice Address - Street 1:7439 CORLISS AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4932
Practice Address - Country:US
Practice Address - Phone:206-523-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor