Provider Demographics
NPI:1629257696
Name:SOUTH TACOMA CHIROPRACTIC AND REHABILITATION, PLLC
Entity Type:Organization
Organization Name:SOUTH TACOMA CHIROPRACTIC AND REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURRUBIATE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-531-1000
Mailing Address - Street 1:8833 PACIFIC AVE STE C
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-6490
Mailing Address - Country:US
Mailing Address - Phone:253-531-1000
Mailing Address - Fax:253-531-0967
Practice Address - Street 1:8833 PACIFIC AVE STE C
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-6490
Practice Address - Country:US
Practice Address - Phone:253-531-1000
Practice Address - Fax:253-531-0967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB35158Medicare PIN