Provider Demographics
NPI:1629362025
Name:180 DEGREES CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:180 DEGREES CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALIMENT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-636-8354
Mailing Address - Street 1:16150 NE 85TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3539
Mailing Address - Country:US
Mailing Address - Phone:425-636-8354
Mailing Address - Fax:425-636-8445
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3539
Practice Address - Country:US
Practice Address - Phone:425-636-8354
Practice Address - Fax:425-636-8445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60175587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty