Provider Demographics
NPI:1942747936
Name:ACUTE CHIROPRACTIC YAKIMA LLC
Entity Type:Organization
Organization Name:ACUTE CHIROPRACTIC YAKIMA LLC
Other - Org Name:ACUTE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-579-0270
Mailing Address - Street 1:PO BOX 5565
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0565
Mailing Address - Country:US
Mailing Address - Phone:509-902-1222
Mailing Address - Fax:509-902-1223
Practice Address - Street 1:2405 W WASHINGTON AVE STE 140
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-2518
Practice Address - Country:US
Practice Address - Phone:509-902-1222
Practice Address - Fax:509-902-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60109611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty