Provider Demographics
NPI:1184969974
Name:FAMILY PRACTICE OF CHIROPRACTIC INC. P.S.
Entity type:Organization
Organization Name:FAMILY PRACTICE OF CHIROPRACTIC INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAI
Authorized Official - Middle Name:PO
Authorized Official - Last Name:YIP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-851-1733
Mailing Address - Street 1:P.O. BOX 1206
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-851-1733
Mailing Address - Fax:253-851-4333
Practice Address - Street 1:3312 ROSEDALE ST. N.W.
Practice Address - Street 2:SUITE 104
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-851-1733
Practice Address - Fax:253-851-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty