Provider Demographics
NPI:1245281385
Name:BANKER, DENNIS LEE (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LEE
Last Name:BANKER
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 1:1200 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-7519
Mailing Address - Country:US
Mailing Address - Phone:509-665-8201
Mailing Address - Fax:509-662-9104
Practice Address - Street 1:630 N CHELAN AVE
Practice Address - Street 2:STE A-3
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6622
Practice Address - Country:US
Practice Address - Phone:509-663-5101
Practice Address - Fax:509-662-9104
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002640111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA35756OtherSTATE L&I NUMBER
WAT67409Medicare UPIN