Provider Demographics
NPI:1578229100
Name:WEVE GOT YOUR BACK
Entity Type:Organization
Organization Name:WEVE GOT YOUR BACK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAEMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-647-1895
Mailing Address - Street 1:104 GRAND BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7707
Mailing Address - Country:US
Mailing Address - Phone:360-695-5332
Mailing Address - Fax:
Practice Address - Street 1:104 GRAND BLVD STE 102
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7707
Practice Address - Country:US
Practice Address - Phone:360-695-5332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty