Provider Demographics
NPI:1568608255
Name:MOECKEL CHIROPRACTIC, P.S.
Entity Type:Organization
Organization Name:MOECKEL CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-748-8824
Mailing Address - Street 1:83 SW 13TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3602
Mailing Address - Country:US
Mailing Address - Phone:360-748-8824
Mailing Address - Fax:360-748-8825
Practice Address - Street 1:83 SW 13TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3602
Practice Address - Country:US
Practice Address - Phone:360-748-8824
Practice Address - Fax:360-748-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0242951OtherL&I
WAG8878182Medicare UPIN