Provider Demographics
NPI:1528416724
Name:SIMMONDS CHIROPRACTIC AND WELLNESS INC
Entity Type:Organization
Organization Name:SIMMONDS CHIROPRACTIC AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-265-7922
Mailing Address - Street 1:9621 MICKELBERRY RD NW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8301
Mailing Address - Country:US
Mailing Address - Phone:360-692-5350
Mailing Address - Fax:360-692-5354
Practice Address - Street 1:9621 MICKELBERRY RD NW
Practice Address - Street 2:SUITE 108
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8301
Practice Address - Country:US
Practice Address - Phone:360-692-5350
Practice Address - Fax:360-692-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60643640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA603602318OtherUBI