Provider Demographics
NPI:1720142904
Name:NORTH PINES CHIROPRACTIC PS
Entity Type:Organization
Organization Name:NORTH PINES CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-928-1400
Mailing Address - Street 1:8817 E MISSION AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-5034
Mailing Address - Country:US
Mailing Address - Phone:509-928-1400
Mailing Address - Fax:509-927-3034
Practice Address - Street 1:8817 E MISSION AVE STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-5034
Practice Address - Country:US
Practice Address - Phone:509-928-1400
Practice Address - Fax:509-927-3034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB23233Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER