Provider Demographics
NPI:1699833525
Name:ZINDT, JOHN STEPHEN (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STEPHEN
Last Name:ZINDT
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 1:3819 SOUTH M STREET
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-3933
Mailing Address - Country:US
Mailing Address - Phone:253-473-2232
Mailing Address - Fax:253-473-2236
Practice Address - Street 1:3819 SOUTH M STREET
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-3933
Practice Address - Country:US
Practice Address - Phone:253-473-2232
Practice Address - Fax:253-473-2236
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2014108Medicaid
WA2014108Medicaid
WA1001358Medicare ID - Type Unspecified