Provider Demographics
NPI:1821620238
Name:TAN, JAN VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:JAN VINCENT
Middle Name:
Last Name:TAN
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 1:511 E MAGNOLIA ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4559
Mailing Address - Country:US
Mailing Address - Phone:971-227-7442
Mailing Address - Fax:
Practice Address - Street 1:2930 NEWMARKET ST STE 115
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3870
Practice Address - Country:US
Practice Address - Phone:360-656-5131
Practice Address - Fax:360-656-5131
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61033448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor