Provider Demographics
NPI:1700836814
Name:VERHUNCE, BONNIE JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:JEAN
Last Name:VERHUNCE
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 1:21904 MARINE VIEW DR S
Mailing Address - Street 2:SUITE C
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6103
Mailing Address - Country:US
Mailing Address - Phone:206-824-5521
Mailing Address - Fax:206-212-7455
Practice Address - Street 1:21904 MARINE VIEW DR S
Practice Address - Street 2:SUITE C
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6103
Practice Address - Country:US
Practice Address - Phone:206-824-5521
Practice Address - Fax:206-212-7455
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602003024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0134456OtherLABOR & INDUSTRIES
WA2029312Medicaid
WA0718VEOtherREGENCE RIDER
WA0134456OtherLABOR & INDUSTRIES
WAG8865628Medicare PIN