Provider Demographics
NPI:1922260165
Name:QUEEN ANNE CHIROPRACTIC PS
Entity Type:Organization
Organization Name:QUEEN ANNE CHIROPRACTIC PS
Other - Org Name:QUEEN ANNE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEEBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-282-8275
Mailing Address - Street 1:1905 QUEEN ANNE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2500
Mailing Address - Country:US
Mailing Address - Phone:206-282-8275
Mailing Address - Fax:
Practice Address - Street 1:1905 QUEEN ANNE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2500
Practice Address - Country:US
Practice Address - Phone:206-282-8275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB11498Medicare PIN