Provider Demographics
NPI:1609885839
Name:JUKICH, STEVEN N (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:JUKICH
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 1:711 W JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6409
Mailing Address - Country:US
Mailing Address - Phone:509-328-0579
Mailing Address - Fax:509-328-4806
Practice Address - Street 1:711 W JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6409
Practice Address - Country:US
Practice Address - Phone:509-328-0579
Practice Address - Fax:509-328-4806
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025202CH00001132111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT02509Medicare UPIN
WA349801Medicare ID - Type Unspecified