Provider Demographics
NPI:1922163773
Name:BUTTON CHIROPRACTIC PSC
Entity Type:Organization
Organization Name:BUTTON CHIROPRACTIC PSC
Other - Org Name:BRADLEY K BUTTON DC CCSP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:360-692-2273
Mailing Address - Street 1:9853 SILVERDALE WAY NW STE 107
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7683
Mailing Address - Country:US
Mailing Address - Phone:360-692-2273
Mailing Address - Fax:360-307-7256
Practice Address - Street 1:9853 SILVERDALE WAY NW STE 107
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7683
Practice Address - Country:US
Practice Address - Phone:360-692-2273
Practice Address - Fax:360-307-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2007-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U43001Medicare UPIN
WAG8851602Medicare ID - Type Unspecified