Provider Demographics
NPI:1700221769
Name:WASHBURN, CARA (DC)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:WASHBURN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:BOWLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:914 HEMSATH RD STE 104A
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6582
Mailing Address - Country:US
Mailing Address - Phone:636-724-5757
Mailing Address - Fax:
Practice Address - Street 1:914 HEMSATH RD STE 104A
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6582
Practice Address - Country:US
Practice Address - Phone:636-724-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013012335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor