Provider Demographics
NPI:1760512172
Name:ALDER FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:ALDER FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DEWANE
Authorized Official - Last Name:ALDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-533-9200
Mailing Address - Street 1:225 W FRANCIS AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6304
Mailing Address - Country:US
Mailing Address - Phone:509-533-9200
Mailing Address - Fax:509-533-9300
Practice Address - Street 1:225 W FRANCIS AVE
Practice Address - Street 2:STE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6304
Practice Address - Country:US
Practice Address - Phone:509-533-9200
Practice Address - Fax:509-533-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU61297Medicare UPIN
WAAB35230Medicare PIN