Provider Demographics
NPI:1619401098
Name:BUMGARNER, COURTNEY (DC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BUMGARNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1505
Mailing Address - Country:US
Mailing Address - Phone:509-888-1099
Mailing Address - Fax:
Practice Address - Street 1:100 E 9TH ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1505
Practice Address - Country:US
Practice Address - Phone:269-806-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60733350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor