Provider Demographics
NPI:1629518907
Name:PAQUETTE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PAQUETTE CHIROPRACTIC, PLLC
Other - Org Name:WEST SOUND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-687-0867
Mailing Address - Street 1:3100 NW BUCKLIN HILL RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8358
Mailing Address - Country:US
Mailing Address - Phone:360-830-6596
Mailing Address - Fax:
Practice Address - Street 1:3100 NW BUCKLIN HILL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8358
Practice Address - Country:US
Practice Address - Phone:360-830-6596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60608428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA35Medicare PIN