Provider Demographics
NPI:1750408704
Name:BELLTOWN SPINE AND WELLNESS CENTER, INC., P.S.
Entity type:Organization
Organization Name:BELLTOWN SPINE AND WELLNESS CENTER, INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:V
Authorized Official - Last Name:MINDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-441-7984
Mailing Address - Street 1:2606 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1214
Mailing Address - Country:US
Mailing Address - Phone:206-441-7984
Mailing Address - Fax:206-728-1230
Practice Address - Street 1:2606 3RD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1214
Practice Address - Country:US
Practice Address - Phone:206-441-7984
Practice Address - Fax:206-728-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2614171100000X
WA1278175F00000X
WA3016111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty