Provider Demographics
NPI:1558559385
Name:XIDOS, APHRODITE CORINNE (DC)
Entity Type:Individual
Prefix:DR
First Name:APHRODITE
Middle Name:CORINNE
Last Name:XIDOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:A. CORINNE
Other - Middle Name:
Other - Last Name:XIDOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1401 E JEFFERSON ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5576
Mailing Address - Country:US
Mailing Address - Phone:206-324-2225
Mailing Address - Fax:206-324-5244
Practice Address - Street 1:1401 E JEFFERSON ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5576
Practice Address - Country:US
Practice Address - Phone:206-324-2225
Practice Address - Fax:206-324-5244
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
196797OtherL&I
WA8855379Medicare PIN
G8855018Medicare PIN
196797OtherL&I