Provider Demographics
NPI:1598030892
Name:BROSSARD, DEVIN ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:ALLEN
Last Name:BROSSARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DEVIN
Other - Middle Name:ALLEN
Other - Last Name:BROSSARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3710 168TH ST NE
Mailing Address - Street 2:STE B102
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8463
Mailing Address - Country:US
Mailing Address - Phone:360-722-1578
Mailing Address - Fax:
Practice Address - Street 1:3710 168TH ST NE
Practice Address - Street 2:STE B102
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8463
Practice Address - Country:US
Practice Address - Phone:360-722-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60262639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor