Provider Demographics
NPI:1780856385
Name:MARINER CHIROPRACTIC INC PS
Entity Type:Organization
Organization Name:MARINER CHIROPRACTIC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:FINDLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-692-5350
Mailing Address - Street 1:9621 MICKELBERRY RD NW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-692-5350
Mailing Address - Fax:360-698-0316
Practice Address - Street 1:9621 MICKELBERRY RD NW
Practice Address - Street 2:SUITE 108
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8301
Practice Address - Country:US
Practice Address - Phone:360-692-5350
Practice Address - Fax:360-698-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2022051Medicaid
WA2022051Medicaid