Provider Demographics
NPI:1710624119
Name:DR. JEREMIAH ADEN DC PLLC
Entity Type:Organization
Organization Name:DR. JEREMIAH ADEN DC PLLC
Other - Org Name:DR. JEREMIAH ADEN DC PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:ORIN
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-451-4213
Mailing Address - Street 1:945 HILDEBRAND LN NE STE 210
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3806
Mailing Address - Country:US
Mailing Address - Phone:206-451-4213
Mailing Address - Fax:206-451-4239
Practice Address - Street 1:4450 PALOMINO DR NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-4013
Practice Address - Country:US
Practice Address - Phone:651-230-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty