Provider Demographics
NPI:1356546543
Name:HENKEL FAMILY CHIROPRACTIC, P.S.
Entity type:Organization
Organization Name:HENKEL FAMILY CHIROPRACTIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HENKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-337-5800
Mailing Address - Street 1:1820 100TH PL SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3867
Mailing Address - Country:US
Mailing Address - Phone:425-337-5800
Mailing Address - Fax:425-337-5801
Practice Address - Street 1:1820 100TH PL SE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3867
Practice Address - Country:US
Practice Address - Phone:425-337-5800
Practice Address - Fax:425-337-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty