Provider Demographics
NPI:1639515505
Name:GOULDIN, SKYLER (DC)
Entity type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:
Last Name:GOULDIN
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 1:2121 N WENATCHEE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1057
Mailing Address - Country:US
Mailing Address - Phone:509-293-7050
Mailing Address - Fax:
Practice Address - Street 1:2121 N WENATCHEE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1057
Practice Address - Country:US
Practice Address - Phone:509-293-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60348358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor