Provider Demographics
NPI:1639172646
Name:PRICE, TIMOTHY B (DC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:B
Last Name:PRICE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 EAST 29TH AVE.
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203
Mailing Address - Country:US
Mailing Address - Phone:509-455-7552
Mailing Address - Fax:509-747-6130
Practice Address - Street 1:2020 EAST 29TH AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203
Practice Address - Country:US
Practice Address - Phone:509-455-7552
Practice Address - Fax:509-747-6130
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA602288498OtherUNIFIED BUSINESS ID
WACH00034209OtherCHIROPRACTIC LICENSE
WACH00034209OtherCHIROPRACTIC LICENSE