Provider Demographics
NPI:1821250457
Name:ACTION POTENTIAL CHIROPRACTIC INC. PS
Entity Type:Organization
Organization Name:ACTION POTENTIAL CHIROPRACTIC INC. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-629-2524
Mailing Address - Street 1:848 N SUNRISE BLVD STE 102 BLD A
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282
Mailing Address - Country:US
Mailing Address - Phone:360-629-2524
Mailing Address - Fax:360-610-4979
Practice Address - Street 1:848 N SUNRISE BLVD STE 102 BLD A
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8833
Practice Address - Country:US
Practice Address - Phone:360-629-2524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty