Provider Demographics
NPI:1851662985
Name:NU STAR CHIROPRACTORS OF NW, INC
Entity Type:Organization
Organization Name:NU STAR CHIROPRACTORS OF NW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-451-4465
Mailing Address - Street 1:12015 NE 8TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3141
Mailing Address - Country:US
Mailing Address - Phone:425-451-4465
Mailing Address - Fax:425-462-4247
Practice Address - Street 1:12015 NE 8TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3141
Practice Address - Country:US
Practice Address - Phone:425-451-4465
Practice Address - Fax:425-462-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty