Provider Demographics
NPI:1700921327
Name:SILLIKER, JASON L (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:SILLIKER
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 1:12209 131ST PL NE
Mailing Address - Street 2:#C-54
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-8092
Mailing Address - Country:US
Mailing Address - Phone:425-988-4464
Mailing Address - Fax:
Practice Address - Street 1:820 NE NORTHGATE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7312
Practice Address - Country:US
Practice Address - Phone:206-440-8900
Practice Address - Fax:206-440-8900
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1134111N00000X
WACH00034792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor