Provider Demographics
NPI:1669410148
Name:NWSPRC INC
Entity type:Organization
Organization Name:NWSPRC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KELLOGG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-325-2990
Mailing Address - Street 1:2603 W WELLESLEY AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1582
Mailing Address - Country:US
Mailing Address - Phone:509-325-2944
Mailing Address - Fax:509-327-1830
Practice Address - Street 1:2603 W WELLESLEY AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-1582
Practice Address - Country:US
Practice Address - Phone:509-325-2944
Practice Address - Fax:509-327-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB32811Medicare ID - Type Unspecified