Provider Demographics
NPI:1013937754
Name:FITZPATRICK, JAMES E (DC, PS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:DC, PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 RAINIER BLVD N
Mailing Address - Street 2:STE A
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2826
Mailing Address - Country:US
Mailing Address - Phone:425-392-5321
Mailing Address - Fax:425-392-5321
Practice Address - Street 1:465 RAINIER BLVD N
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2826
Practice Address - Country:US
Practice Address - Phone:425-392-5321
Practice Address - Fax:425-837-3785
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH000000801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT01590Medicare ID - Type Unspecified