Provider Demographics
NPI:1780207241
Name:BALLARD SEATTLE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:BALLARD SEATTLE CHIROPRACTIC CENTER
Other - Org Name:E1SPINE,PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:EYFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-396-1000
Mailing Address - Street 1:601 S PINE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2795
Mailing Address - Country:US
Mailing Address - Phone:253-396-1000
Mailing Address - Fax:
Practice Address - Street 1:5429 RUSSELL AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4010
Practice Address - Country:US
Practice Address - Phone:206-783-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty