Provider Demographics
NPI:1598808081
Name:IGIELSKI, TIMOTHY J (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:J
Last Name:IGIELSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 S 308TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4823
Mailing Address - Country:US
Mailing Address - Phone:253-335-9983
Mailing Address - Fax:253-529-1214
Practice Address - Street 1:2214 S 308TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4823
Practice Address - Country:US
Practice Address - Phone:253-335-9983
Practice Address - Fax:253-529-1214
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0002156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB11180Medicare ID - Type Unspecified