Provider Demographics
NPI:1558486001
Name:WILLIAMS, DERRIK (DC)
Entity Type:Individual
Prefix:DR
First Name:DERRIK
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 RENTON CENTER WAY SW
Mailing Address - Street 2:SUITE F
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2324
Mailing Address - Country:US
Mailing Address - Phone:425-226-7061
Mailing Address - Fax:
Practice Address - Street 1:365 RENTON CENTER WAY SW
Practice Address - Street 2:SUITE F
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2324
Practice Address - Country:US
Practice Address - Phone:425-226-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor