Provider Demographics
NPI:1942330758
Name:ADDLEMAN, J BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:J BRIAN
Middle Name:
Last Name:ADDLEMAN
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 1:100 VALLEY MALL PKWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5348
Mailing Address - Country:US
Mailing Address - Phone:509-884-3368
Mailing Address - Fax:509-884-4720
Practice Address - Street 1:100 VALLEY MALL PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5348
Practice Address - Country:US
Practice Address - Phone:509-884-3368
Practice Address - Fax:509-884-4720
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA17992OtherDLI
350003021OtherRAILROAD MEDICARE