Provider Demographics
NPI:1629258702
Name:THOMPSON CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:THOMPSON CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:BRIGHTON
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-825-5757
Mailing Address - Street 1:1624 PIONEER ST.
Mailing Address - Street 2:STE. A
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2299
Mailing Address - Country:US
Mailing Address - Phone:360-825-5757
Mailing Address - Fax:360-825-5784
Practice Address - Street 1:1624 PIONEER ST STE A
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2299
Practice Address - Country:US
Practice Address - Phone:360-825-5757
Practice Address - Fax:360-825-5784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3013261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB26203OtherMEDICARE DR#
WAAB26203Medicare PIN
WAAB25891Medicare PIN
WAGAB25891Medicare PIN