Provider Demographics
NPI:1598157406
Name:FLOURISH CHIROPRACTIC OF SEATTLE
Entity Type:Organization
Organization Name:FLOURISH CHIROPRACTIC OF SEATTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERONA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-851-2242
Mailing Address - Street 1:417 E PINE ST
Mailing Address - Street 2:STE P
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2395
Mailing Address - Country:US
Mailing Address - Phone:206-851-2242
Mailing Address - Fax:
Practice Address - Street 1:417 E PINE ST
Practice Address - Street 2:STE P
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2395
Practice Address - Country:US
Practice Address - Phone:206-851-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60308068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty