Provider Demographics
NPI:1891149266
Name:SALO, SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SALO
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 1:19689 7TH AVE NE
Mailing Address - Street 2:#237
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8091
Mailing Address - Country:US
Mailing Address - Phone:360-697-2122
Mailing Address - Fax:
Practice Address - Street 1:19586 10TH AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7332
Practice Address - Country:US
Practice Address - Phone:360-697-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor