Provider Demographics
NPI:1679181952
Name:HATCHER, SHAKA (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAKA
Middle Name:
Last Name:HATCHER
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 1:3121 E MADISON ST STE 103A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4238
Mailing Address - Country:US
Mailing Address - Phone:206-326-8448
Mailing Address - Fax:
Practice Address - Street 1:3121 E MADISON ST STE 103A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4238
Practice Address - Country:US
Practice Address - Phone:206-326-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61025724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor