Provider Demographics
NPI:1679769186
Name:BUTTERFIELD CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:BUTTERFIELD CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRECK
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:424-424-2112
Mailing Address - Street 1:18500 156TH AVE NE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-4459
Mailing Address - Country:US
Mailing Address - Phone:425-424-2112
Mailing Address - Fax:425-424-2127
Practice Address - Street 1:18500 156TH AVE NE
Practice Address - Street 2:SUITE 205
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-4459
Practice Address - Country:US
Practice Address - Phone:425-424-2112
Practice Address - Fax:425-424-2127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB32815Medicare PIN