Provider Demographics
NPI:1871659698
Name:PLAISANCE, LORIE A (DC)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:A
Last Name:PLAISANCE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LORIE
Other - Middle Name:A
Other - Last Name:PLAISANCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3212 NW BYRON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9154
Mailing Address - Country:US
Mailing Address - Phone:360-692-2333
Mailing Address - Fax:360-692-2334
Practice Address - Street 1:3212 NW BYRON ST STE STE103
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9154
Practice Address - Country:US
Practice Address - Phone:360-692-2333
Practice Address - Fax:360-692-2334
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0114964OtherLABOR AND INDUSTRY
WA651382001OtherIRS
WAGAB01199Medicare PIN
U96668Medicare UPIN