Provider Demographics
NPI:1639501810
Name:ASHLEY, MICHAEL THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:ASHLEY
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 1:18001 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6895
Mailing Address - Country:US
Mailing Address - Phone:425-487-0487
Mailing Address - Fax:425-486-4548
Practice Address - Street 1:18001 BOTHELL EVERETT HWY
Practice Address - Street 2:SUITE 108
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-6895
Practice Address - Country:US
Practice Address - Phone:425-487-0487
Practice Address - Fax:425-486-4548
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA15894OtherWASHINGTON DEPT OF LABOR AND INDUSTRIES
WA105260OtherWASHINGTON DEPT OF LABOR AND INDUSTRIES