Provider Demographics
NPI:1710128103
Name:SHUMAKER, BRANDON ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ERIC
Last Name:SHUMAKER
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 584
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-0584
Mailing Address - Country:US
Mailing Address - Phone:360-271-3349
Mailing Address - Fax:
Practice Address - Street 1:1501 POTTERY AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3712
Practice Address - Country:US
Practice Address - Phone:360-876-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60071763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor