Provider Demographics
NPI:1013320308
Name:WASHINGTON SPINE AND WELLNESS LLC
Entity Type:Organization
Organization Name:WASHINGTON SPINE AND WELLNESS LLC
Other - Org Name:MONROE CHIROPRACTIC AND ALTERNATIVE MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STROHM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-794-4500
Mailing Address - Street 1:328 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1812
Mailing Address - Country:US
Mailing Address - Phone:360-794-4500
Mailing Address - Fax:
Practice Address - Street 1:5401 LEARY AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4070
Practice Address - Country:US
Practice Address - Phone:206-582-3471
Practice Address - Fax:206-582-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60191938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty