Provider Demographics
NPI:1659509230
Name:BALDWIN, STEPHEN (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BALDWIN
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 1:17416 SR 9 SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296
Mailing Address - Country:US
Mailing Address - Phone:360-668-2000
Mailing Address - Fax:360-668-1700
Practice Address - Street 1:17416 SR 9
Practice Address - Street 2:SUITE B
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-6304
Practice Address - Country:US
Practice Address - Phone:360-668-2000
Practice Address - Fax:360-668-1700
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor