Provider Demographics
NPI:1710171178
Name:FEARN NATURAL HEALTH CARE, INC. PC
Entity Type:Organization
Organization Name:FEARN NATURAL HEALTH CARE, INC. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FEARN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-834-6964
Mailing Address - Street 1:602 NE 3RD AVE STE E
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2152
Mailing Address - Country:US
Mailing Address - Phone:360-834-6964
Mailing Address - Fax:360-834-6847
Practice Address - Street 1:602 NE 3RD AVE STE E
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2152
Practice Address - Country:US
Practice Address - Phone:360-834-6964
Practice Address - Fax:360-834-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB04604Medicare UPIN