Provider Demographics
NPI:1205913415
Name:PRATT CLINIC OF CHIROPRACTIC PS
Entity type:Organization
Organization Name:PRATT CLINIC OF CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-782-1312
Mailing Address - Street 1:102 COTTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815
Mailing Address - Country:US
Mailing Address - Phone:509-782-1312
Mailing Address - Fax:509-782-1733
Practice Address - Street 1:102 COTTAGE AVE
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815
Practice Address - Country:US
Practice Address - Phone:509-782-1312
Practice Address - Fax:509-782-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA13460OtherL&I
WA8349581Medicaid
WA13460OtherL&I
WA88868939Medicare PIN