Provider Demographics
NPI:1023066099
Name:SWEET, JAY B (DC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:B
Last Name:SWEET
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 1:3535 MARTIN WAY E
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5049
Mailing Address - Country:US
Mailing Address - Phone:360-455-3272
Mailing Address - Fax:360-923-9382
Practice Address - Street 1:3535 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5049
Practice Address - Country:US
Practice Address - Phone:360-455-3272
Practice Address - Fax:360-923-9382
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH3461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU67845Medicare UPIN
WAAB01964Medicare ID - Type Unspecified