Provider Demographics
NPI:1578200911
Name:TRIPP, EMILY (DC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TRIPP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4826 226TH PL NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-7286
Mailing Address - Country:US
Mailing Address - Phone:425-783-9718
Mailing Address - Fax:
Practice Address - Street 1:2770 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1557
Practice Address - Country:US
Practice Address - Phone:248-397-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor