Provider Demographics
NPI:1952490401
Name:BARNICK, ROGER ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:ANTHONY
Last Name:BARNICK
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 1:3606 MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2257
Mailing Address - Country:US
Mailing Address - Phone:360-693-7781
Mailing Address - Fax:360-693-1688
Practice Address - Street 1:3606 MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2257
Practice Address - Country:US
Practice Address - Phone:360-693-7781
Practice Address - Fax:360-693-1688
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60032144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8878133OtherPTAN