Provider Demographics
NPI:1568666188
Name:HEMPHILL CHIROPRACTIC
Entity Type:Organization
Organization Name:HEMPHILL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BERGQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-226-7061
Mailing Address - Street 1:365 RENTON CENTER WAY SW STE F
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2324
Mailing Address - Country:US
Mailing Address - Phone:206-749-0169
Mailing Address - Fax:206-623-2196
Practice Address - Street 1:365 RENTON CENTER WAY SW STE F
Practice Address - Street 2:
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:425-226-7063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty