Provider Demographics
NPI:1336260058
Name:NOTHWEST CHIROPRACTIC CENTER NORTH
Entity Type:Organization
Organization Name:NOTHWEST CHIROPRACTIC CENTER NORTH
Other - Org Name:GUTIERREZ FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-658-3818
Mailing Address - Street 1:PO BOX 3069
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-3069
Mailing Address - Country:US
Mailing Address - Phone:360-658-3818
Mailing Address - Fax:360-651-2344
Practice Address - Street 1:3704 172ND ST NE
Practice Address - Street 2:SUITE N
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6336
Practice Address - Country:US
Practice Address - Phone:360-658-3818
Practice Address - Fax:360-651-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA=========OtherTAX ID