Provider Demographics
NPI:1871651059
Name:SPENCER, PHILIP GERARD (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:GERARD
Last Name:SPENCER
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 1:1010 S 336TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7354
Mailing Address - Country:US
Mailing Address - Phone:253-874-9001
Mailing Address - Fax:253-874-9051
Practice Address - Street 1:1010 S 336TH ST STE 120
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7354
Practice Address - Country:US
Practice Address - Phone:253-874-9001
Practice Address - Fax:253-874-9051
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor