Provider Demographics
NPI:1639475494
Name:ASATUROV, ALEXSANDR B (DC)
Entity Type:Individual
Prefix:
First Name:ALEXSANDR
Middle Name:B
Last Name:ASATUROV
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 1:2107 ELLIOTT AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2138
Mailing Address - Country:US
Mailing Address - Phone:206-441-0109
Mailing Address - Fax:206-441-3021
Practice Address - Street 1:2107 ELLIOTT AVE STE 203
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2138
Practice Address - Country:US
Practice Address - Phone:206-441-0109
Practice Address - Fax:206-441-3021
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60176644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor