Provider Demographics
NPI:1013554856
Name:MOBILE CHIROPRACTIC NORTH WEST , INC.
Entity Type:Organization
Organization Name:MOBILE CHIROPRACTIC NORTH WEST , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:FATEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-909-1800
Mailing Address - Street 1:9403 NE 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-2338
Mailing Address - Country:US
Mailing Address - Phone:360-909-1800
Mailing Address - Fax:
Practice Address - Street 1:9403 NE 116TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-2338
Practice Address - Country:US
Practice Address - Phone:360-909-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty