Provider Demographics
NPI:1922115112
Name:ARELLANO, JEFFREY WD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WD
Last Name:ARELLANO
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 1:2010 W LINCOLN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2413
Mailing Address - Country:US
Mailing Address - Phone:509-972-4422
Mailing Address - Fax:509-972-4455
Practice Address - Street 1:2010 W LINCOLN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2413
Practice Address - Country:US
Practice Address - Phone:509-972-4422
Practice Address - Fax:509-972-4455
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH34282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U98735Medicare UPIN