Provider Demographics
NPI:1679693675
Name:PRICE, DIANE (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32256 NE 88TH ST
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-6700
Mailing Address - Country:US
Mailing Address - Phone:425-691-7594
Mailing Address - Fax:
Practice Address - Street 1:32256 NE 88TH ST
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-6700
Practice Address - Country:US
Practice Address - Phone:425-691-7594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH2778111N00000X
WAMA5058225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU622211Medicare UPIN