Provider Demographics
NPI:1568737047
Name:PAIN FREE MOVE WELL
Entity Type:Organization
Organization Name:PAIN FREE MOVE WELL
Other - Org Name:PAIN FREE MOVE WELL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-802-3391
Mailing Address - Street 1:21907 64TH AVE W STE 110
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2298
Mailing Address - Country:US
Mailing Address - Phone:425-774-6876
Mailing Address - Fax:425-775-2739
Practice Address - Street 1:21907 64TH AVE W STE 110
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2298
Practice Address - Country:US
Practice Address - Phone:425-774-6876
Practice Address - Fax:425-775-2739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034535111N00000X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty