Provider Demographics
NPI:1922279686
Name:JOLLY WAY HEALTH INC., P.S. DBA MERCER WELLNESS
Entity Type:Organization
Organization Name:JOLLY WAY HEALTH INC., P.S. DBA MERCER WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARRELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-275-4870
Mailing Address - Street 1:7605 SE 27TH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2835
Mailing Address - Country:US
Mailing Address - Phone:206-275-4870
Mailing Address - Fax:206-275-4876
Practice Address - Street 1:7605 SE 27TH ST
Practice Address - Street 2:STE 103
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2835
Practice Address - Country:US
Practice Address - Phone:206-275-4870
Practice Address - Fax:206-275-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty