Provider Demographics
NPI:1538496971
Name:INBALANCE SPINAL HEALTH & WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:INBALANCE SPINAL HEALTH & WELLNESS CENTER PLLC
Other - Org Name:REDMOND SPINAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:O'BRIEN
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-710-5641
Mailing Address - Street 1:15600 REDMOND WAY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3862
Mailing Address - Country:US
Mailing Address - Phone:425-881-5811
Mailing Address - Fax:425-881-6220
Practice Address - Street 1:15600 REDMOND WAY
Practice Address - Street 2:SUITE 302
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:425-881-5811
Practice Address - Fax:425-881-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60105748261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center