Provider Demographics
NPI:1356433726
Name:BAHM, DAVID EMIL (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EMIL
Last Name:BAHM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2908 228TH AVE SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-9306
Mailing Address - Country:US
Mailing Address - Phone:425-391-4095
Mailing Address - Fax:425-391-6059
Practice Address - Street 1:2908 228TH AVE SE
Practice Address - Street 2:SUITE C
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-9306
Practice Address - Country:US
Practice Address - Phone:425-391-4095
Practice Address - Fax:425-391-6059
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1225159940OtherCLINIC NPI
WABA 4012OtherOTHER
WABA 4012OtherOTHER