Provider Demographics
NPI:1992866370
Name:FITZPATRICK, AARON J (DC LMP)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:J
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:DC LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12955
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508
Mailing Address - Country:US
Mailing Address - Phone:360-754-2915
Mailing Address - Fax:360-754-6919
Practice Address - Street 1:1700 COOPER POINT RD SW
Practice Address - Street 2:SUITE A 1
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502
Practice Address - Country:US
Practice Address - Phone:360-754-2915
Practice Address - Fax:360-754-6919
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034037111N00000X
WAMA00010481225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1700FIOtherREGENCE
WA5394FIOtherREGENCE
WA5394FIOtherREGENCE
WAGAB24845Medicare ID - Type Unspecified