Provider Demographics
NPI:1710074307
Name:ARNDT, RUSSELL C (DC)
Entity Type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:C
Last Name:ARNDT
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:PO BOX 902
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-0902
Mailing Address - Country:US
Mailing Address - Phone:509-826-1434
Mailing Address - Fax:509-826-1448
Practice Address - Street 1:13 N ASH ST
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841
Practice Address - Country:US
Practice Address - Phone:509-826-1434
Practice Address - Fax:509-836-1448
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000304801Medicare ID - Type Unspecified
U40887Medicare UPIN