Provider Demographics
NPI:1639395965
Name:SHERWOOD PALMER, DIANE M (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:M
Last Name:SHERWOOD PALMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10767 16TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146
Mailing Address - Country:US
Mailing Address - Phone:206-242-3700
Mailing Address - Fax:206-439-0175
Practice Address - Street 1:10767 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146
Practice Address - Country:US
Practice Address - Phone:206-242-3700
Practice Address - Fax:206-439-0175
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA69102OtherL AND I
WA69102OtherL AND I
T01825Medicare UPIN