Provider Demographics
NPI:1154576882
Name:LEWIS FAMILY CHIROPRACTIC & WELLNESS, PLLC
Entity type:Organization
Organization Name:LEWIS FAMILY CHIROPRACTIC & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-858-9783
Mailing Address - Street 1:3214 50TH STREET CT NW
Mailing Address - Street 2:STE. 204
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8589
Mailing Address - Country:US
Mailing Address - Phone:253-858-9783
Mailing Address - Fax:253-444-3783
Practice Address - Street 1:3214 50TH STREET CT NW
Practice Address - Street 2:STE. 204
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8589
Practice Address - Country:US
Practice Address - Phone:253-858-9783
Practice Address - Fax:253-444-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty