Provider Demographics
NPI:1568651636
Name:WARNINGER CHIROPRACTIC CLINIC - SELAH OFFICE
Entity Type:Organization
Organization Name:WARNINGER CHIROPRACTIC CLINIC - SELAH OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-697-4838
Mailing Address - Street 1:9 E 1ST AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1400
Mailing Address - Country:US
Mailing Address - Phone:509-697-4838
Mailing Address - Fax:
Practice Address - Street 1:9 E 1ST AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1400
Practice Address - Country:US
Practice Address - Phone:509-697-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83755Medicare UPIN
AB24480Medicare PIN
AB12583Medicare PIN