Provider Demographics
NPI:1538319702
Name:JOSEPH A URQUIA PS
Entity Type:Organization
Organization Name:JOSEPH A URQUIA PS
Other - Org Name:FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:URQUIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-452-6888
Mailing Address - Street 1:1111 E FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-4307
Mailing Address - Country:US
Mailing Address - Phone:360-452-6888
Mailing Address - Fax:360-457-3550
Practice Address - Street 1:1111 E FRONT STREET
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-4307
Practice Address - Country:US
Practice Address - Phone:360-452-6888
Practice Address - Fax:360-457-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA83407OtherLABOR & IND
WA07714OtherREGENCE B/S
WA07714OtherREGENCE B/S