Provider Demographics
NPI:1649550427
Name:WORD, JEFFREY CLOYD LELAND (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CLOYD LELAND
Last Name:WORD
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 1:1400 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2802
Mailing Address - Country:US
Mailing Address - Phone:206-323-0114
Mailing Address - Fax:844-329-1722
Practice Address - Street 1:1400 20TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2802
Practice Address - Country:US
Practice Address - Phone:206-323-0114
Practice Address - Fax:844-329-1722
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60239267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1164970778OtherGROUP NPI
1649550427OtherNPI
WAG8905255Medicare UPIN