Provider Demographics
NPI:1609973676
Name:HUNT, RAYNEL J (DC)
Entity Type:Individual
Prefix:
First Name:RAYNEL
Middle Name:J
Last Name:HUNT
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:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-0246
Mailing Address - Country:US
Mailing Address - Phone:360-835-3150
Mailing Address - Fax:360-835-0459
Practice Address - Street 1:1901 MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-4116
Practice Address - Country:US
Practice Address - Phone:360-835-3150
Practice Address - Fax:360-835-0459
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60096097111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8899686OtherMEDICARE UNSPECIFIED