Provider Demographics
NPI:1619144565
Name:EARLY DAWN ENTERPRISES INC.
Entity Type:Organization
Organization Name:EARLY DAWN ENTERPRISES INC.
Other - Org Name:BACK IN ACTION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JON
Authorized Official - Last Name:WEIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-635-0495
Mailing Address - Street 1:1940 116TH AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3011
Mailing Address - Country:US
Mailing Address - Phone:425-635-0495
Mailing Address - Fax:425-289-0140
Practice Address - Street 1:2320 130TH AVE NE STE 210
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1752
Practice Address - Country:US
Practice Address - Phone:425-635-0495
Practice Address - Fax:425-289-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty