Provider Demographics
NPI:1518226117
Name:FERRILL, MITZI BETH (DC)
Entity Type:Individual
Prefix:DR
First Name:MITZI
Middle Name:BETH
Last Name:FERRILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MITZI
Other - Middle Name:BETH
Other - Last Name:YERRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1498
Mailing Address - Street 2:LOWER SUITE
Mailing Address - City:STEVENSON
Mailing Address - State:WA
Mailing Address - Zip Code:98648-1498
Mailing Address - Country:US
Mailing Address - Phone:509-427-3600
Mailing Address - Fax:
Practice Address - Street 1:27 SW RUSSELL AVE
Practice Address - Street 2:LOWER SUITE
Practice Address - City:STEVENSON
Practice Address - State:WA
Practice Address - Zip Code:98648-9198
Practice Address - Country:US
Practice Address - Phone:509-427-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60264407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor