Provider Demographics
NPI:1710350806
Name:HA, ANTHONY TOAN-ANH (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TOAN-ANH
Last Name:HA
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 1:4007 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-5825
Mailing Address - Country:US
Mailing Address - Phone:509-443-3424
Mailing Address - Fax:509-315-8502
Practice Address - Street 1:4007 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5825
Practice Address - Country:US
Practice Address - Phone:509-443-3424
Practice Address - Fax:509-315-8502
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60540142111N00000X, 111NN1001X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA603 543 769OtherTAX ID OR BUSINESS LICENSE