Provider Demographics
NPI:1760670137
Name:GALARNEAU, RUSSELL G (DC)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:G
Last Name:GALARNEAU
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 1:3123 56TH ST NW STE 4
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1363
Mailing Address - Country:US
Mailing Address - Phone:253-851-7711
Mailing Address - Fax:253-851-7713
Practice Address - Street 1:3123 56TH ST NW STE 4
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1363
Practice Address - Country:US
Practice Address - Phone:253-851-7711
Practice Address - Fax:253-851-7713
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU35550Medicare UPIN