Provider Demographics
NPI:1588673768
Name:HEALTH FIRST CHIROPRACTIC INC PS
Entity Type:Organization
Organization Name:HEALTH FIRST CHIROPRACTIC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LENARZ
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:360-855-1021
Mailing Address - Street 1:700 MURDOCK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1426
Mailing Address - Country:US
Mailing Address - Phone:360-855-1021
Mailing Address - Fax:360-855-0356
Practice Address - Street 1:700 MURDOCK ST
Practice Address - Street 2:SUITE B
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1426
Practice Address - Country:US
Practice Address - Phone:360-855-1021
Practice Address - Fax:360-855-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002269111N00000X
WACH00034404111N00000X
WACH00034638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA001100376Medicare PIN