Provider Demographics
NPI:1609015247
Name:HARTFORD, FORREST R E (DC)
Entity Type:Individual
Prefix:DR
First Name:FORREST
Middle Name:R E
Last Name:HARTFORD
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 1:5125 OLYMPIC DR NW STE 110
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1712
Mailing Address - Country:US
Mailing Address - Phone:253-853-4000
Mailing Address - Fax:253-853-4001
Practice Address - Street 1:5125 OLYMPIC DR NW STE 110
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1712
Practice Address - Country:US
Practice Address - Phone:253-853-4000
Practice Address - Fax:253-853-4001
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH6006715111N00000X
WACH60066715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor