Provider Demographics
NPI:1700894680
Name:WEARY, DANA M (DC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:WEARY
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 1:1410 NORTH MULLAN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206
Mailing Address - Country:US
Mailing Address - Phone:509-927-8997
Mailing Address - Fax:509-927-3919
Practice Address - Street 1:1410 NORTH MULLAN
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206
Practice Address - Country:US
Practice Address - Phone:509-927-8997
Practice Address - Fax:509-927-3919
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T02439Medicare UPIN
WAG8801713Medicare PIN