Provider Demographics
NPI:1528044203
Name:AINSLIE, MARK P (DC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:P
Last Name:AINSLIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:8202 N GENERAL LEE WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5790
Mailing Address - Country:US
Mailing Address - Phone:509-464-2273
Mailing Address - Fax:509-242-1854
Practice Address - Street 1:3809 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2853
Practice Address - Country:US
Practice Address - Phone:509-326-3795
Practice Address - Fax:509-325-7418
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U1562Medicare UPIN
WAG319200004Medicare PIN