Provider Demographics
NPI:1619015906
Name:GITHENS, DUANE F (DC)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:F
Last Name:GITHENS
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 1:2323 N 31ST ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3366
Mailing Address - Country:US
Mailing Address - Phone:253-752-3484
Mailing Address - Fax:253-752-2930
Practice Address - Street 1:2323 N 31ST ST
Practice Address - Street 2:STE. 100
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3366
Practice Address - Country:US
Practice Address - Phone:253-752-3484
Practice Address - Fax:253-752-2930
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGI3881OtherREGENCE
WA13610OtherL&I
WA13610OtherL&I
WAT01608Medicare UPIN
WA8859576Medicare ID - Type Unspecified