Provider Demographics
NPI:1134592975
Name:MATSCH, JENNIFER ERIN (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ERIN
Last Name:MATSCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 N MULLAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4043
Mailing Address - Country:US
Mailing Address - Phone:509-927-8997
Mailing Address - Fax:
Practice Address - Street 1:1410 N MULLAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4043
Practice Address - Country:US
Practice Address - Phone:509-927-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60605301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor