Provider Demographics
NPI:1255697603
Name:PINNACLE HEALTH PS
Entity type:Organization
Organization Name:PINNACLE HEALTH PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRAD
Authorized Official - Last Name:ULRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-644-5556
Mailing Address - Street 1:13742 97TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1874
Mailing Address - Country:US
Mailing Address - Phone:425-644-5556
Mailing Address - Fax:425-664-3174
Practice Address - Street 1:15935 NE 8TH ST
Practice Address - Street 2:SUITE A101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3918
Practice Address - Country:US
Practice Address - Phone:425-644-5556
Practice Address - Fax:425-664-3174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty