Provider Demographics
NPI:1740744655
Name:DODGE MEDICAL, INC.
Entity Type:Organization
Organization Name:DODGE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-683-5995
Mailing Address - Street 1:2111 N NORTHGATE WAY STE 221
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9018
Mailing Address - Country:US
Mailing Address - Phone:206-525-8012
Mailing Address - Fax:206-525-8013
Practice Address - Street 1:2111 N NORTHGATE WAY STE 221
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9018
Practice Address - Country:US
Practice Address - Phone:206-525-8012
Practice Address - Fax:206-525-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty