Provider Demographics
NPI:1659088565
Name:POW, CONNOR (DC)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:
Last Name:POW
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 1:7302 NE 18TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7386
Mailing Address - Country:US
Mailing Address - Phone:360-750-7220
Mailing Address - Fax:
Practice Address - Street 1:7302 NE 18TH ST STE 102
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7386
Practice Address - Country:US
Practice Address - Phone:360-750-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61353001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor