Provider Demographics
NPI:1790089118
Name:BRIAN A HOWLETT CHIROPRACTIC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:BRIAN A HOWLETT CHIROPRACTIC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:HOWLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-758-4357
Mailing Address - Street 1:428 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1920
Mailing Address - Country:US
Mailing Address - Phone:509-758-4357
Mailing Address - Fax:509-758-9122
Practice Address - Street 1:428 5TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1920
Practice Address - Country:US
Practice Address - Phone:509-758-4357
Practice Address - Fax:509-758-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2013605Medicaid
WA2013605Medicaid