Provider Demographics
NPI:1891825196
Name:SMITHSON CHIROPRACTIC P.L.L.C
Entity Type:Organization
Organization Name:SMITHSON CHIROPRACTIC P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SMITHSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-783-7242
Mailing Address - Street 1:2411 S. UNION ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338
Mailing Address - Country:US
Mailing Address - Phone:509-783-7242
Mailing Address - Fax:509-783-7286
Practice Address - Street 1:2411 S. UNION ST.
Practice Address - Street 2:SUITE C
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338
Practice Address - Country:US
Practice Address - Phone:509-783-7242
Practice Address - Fax:509-783-7286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2074261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB15638Medicare ID - Type Unspecified
WAT02427Medicare UPIN