Provider Demographics
NPI:1750666434
Name:HONTZ, JASON KYLE (DC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:KYLE
Last Name:HONTZ
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 1:55 NW WALL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-3200
Mailing Address - Country:US
Mailing Address - Phone:541-389-4321
Mailing Address - Fax:541-389-4420
Practice Address - Street 1:11314 4TH AVE W
Practice Address - Street 2:STE 103
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6926
Practice Address - Country:US
Practice Address - Phone:425-355-3739
Practice Address - Fax:425-514-8353
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60238068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor