Provider Demographics
NPI:1558391417
Name:PIER VIEW CHIROPRACTIC, INC. PS
Entity Type:Organization
Organization Name:PIER VIEW CHIROPRACTIC, INC. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GENIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCWP
Authorized Official - Phone:206-824-7200
Mailing Address - Street 1:19987 1ST AVE S STE 102
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98148-2400
Mailing Address - Country:US
Mailing Address - Phone:206-824-7200
Mailing Address - Fax:206-832-4652
Practice Address - Street 1:19987 1ST AVE S STE 102
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2400
Practice Address - Country:US
Practice Address - Phone:206-824-7200
Practice Address - Fax:206-832-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034082111N00000X, 111N00000X
WAMA60124192225700000X, 225700000X
WAMA60524185225700000X
WAMA60016934225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1316335490Medicaid
WA1013245810Medicaid
WA1407886468Medicaid
WA1316335490Medicaid