Provider Demographics
NPI:1669860052
Name:CHEVIGNY, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHEVIGNY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 NE 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7129
Mailing Address - Country:US
Mailing Address - Phone:206-523-9000
Mailing Address - Fax:206-523-5566
Practice Address - Street 1:11821 NE 128TH ST STE B
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7210
Practice Address - Country:US
Practice Address - Phone:425-814-2800
Practice Address - Fax:425-823-0882
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60522163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1669860052OtherNPI