Provider Demographics
NPI:1760888085
Name:BLUE SPRING CHIROPRACTIC
Entity Type:Organization
Organization Name:BLUE SPRING CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMP
Authorized Official - Prefix:
Authorized Official - First Name:ARIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:AALONA
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:253-495-0568
Mailing Address - Street 1:12811 SE 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1326
Mailing Address - Country:US
Mailing Address - Phone:425-644-7582
Mailing Address - Fax:
Practice Address - Street 1:12811 SE 38TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1326
Practice Address - Country:US
Practice Address - Phone:425-644-7582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603075072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty