Provider Demographics
NPI:1598867673
Name:AKRIDGE, SCOTT KELLY (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:KELLY
Last Name:AKRIDGE
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 1:8511 W CLEARWATER AVE STE B
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-9592
Mailing Address - Country:US
Mailing Address - Phone:509-783-8145
Mailing Address - Fax:509-783-8147
Practice Address - Street 1:8511 W CLEARWATER AVE STE B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-9592
Practice Address - Country:US
Practice Address - Phone:509-783-8145
Practice Address - Fax:509-783-8147
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000300021Medicare UPIN
WA000300021Medicare ID - Type Unspecified
G8914971Medicare UPIN