Provider Demographics
NPI:1740387398
Name:CHARD, FREDERICK HARRISON (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:HARRISON
Last Name:CHARD
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 1:1840 130TH AVE NE STE 7
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2228
Mailing Address - Country:US
Mailing Address - Phone:425-883-6067
Mailing Address - Fax:
Practice Address - Street 1:1840 130TH AVE NE STE 7
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2228
Practice Address - Country:US
Practice Address - Phone:425-883-6067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA 3073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor