Provider Demographics
NPI:1942397351
Name:POLLARD, CORRIE L (DC)
Entity Type:Individual
Prefix:
First Name:CORRIE
Middle Name:L
Last Name:POLLARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13003 SE KENT KANGLEY
Mailing Address - Street 2:STE 110
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98006
Mailing Address - Country:US
Mailing Address - Phone:253-638-2424
Mailing Address - Fax:253-639-5115
Practice Address - Street 1:13003 SE KENT KANGLEY
Practice Address - Street 2:STE 110
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98006
Practice Address - Country:US
Practice Address - Phone:253-638-2424
Practice Address - Fax:253-639-5115
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U60419Medicare UPIN
WAAB33662Medicare PIN