Provider Demographics
NPI:1609927516
Name:PEARSON, JAY SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:SCOTT
Last Name:PEARSON
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 1:15610 SE 272ND ST STE A-106
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4416
Mailing Address - Country:US
Mailing Address - Phone:253-638-2424
Mailing Address - Fax:253-639-5115
Practice Address - Street 1:15610 SE 272ND ST STE A-106
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4416
Practice Address - Country:US
Practice Address - Phone:253-638-2424
Practice Address - Fax:253-639-5115
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U87860Medicare UPIN
WAAB34636Medicare ID - Type Unspecified