Provider Demographics
NPI:1760628986
Name:YOUR NEIGHBORHOOD HEALTHCARE CENTER PLLC
Entity Type:Organization
Organization Name:YOUR NEIGHBORHOOD HEALTHCARE CENTER PLLC
Other - Org Name:KLAHANIE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:LICHTENWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-391-5050
Mailing Address - Street 1:4556 KLAHANIE DR SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5812
Mailing Address - Country:US
Mailing Address - Phone:425-391-5050
Mailing Address - Fax:425-391-0758
Practice Address - Street 1:4556 KLAHANIE DR SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-5812
Practice Address - Country:US
Practice Address - Phone:425-391-5050
Practice Address - Fax:425-391-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty