Provider Demographics
NPI:1578099925
Name:DELUCCHI LLC
Entity Type:Organization
Organization Name:DELUCCHI LLC
Other - Org Name:TUTTLE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELUCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-908-9545
Mailing Address - Street 1:2705 155TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 SPRING ST
Practice Address - Street 2:SUITE 123
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1014
Practice Address - Country:US
Practice Address - Phone:206-467-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60632389111N00000X
WACH60450085111N00000X
WAMA00024412225700000X
WAMA00023316225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty