Provider Demographics
NPI:1801033030
Name:LEWCHUK, STANLEY BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:BRIAN
Last Name:LEWCHUK
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 1:12310 N DIVISION ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1998
Mailing Address - Country:US
Mailing Address - Phone:509-710-2924
Mailing Address - Fax:509-464-0578
Practice Address - Street 1:12310 N DIVISION ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1998
Practice Address - Country:US
Practice Address - Phone:509-710-2924
Practice Address - Fax:509-464-0578
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8880669Medicare PIN