Provider Demographics
NPI:1750440798
Name:SLOAN, DAVID (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SLOAN
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 1:911 5TH AVE SE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1534
Mailing Address - Country:US
Mailing Address - Phone:360-956-3900
Mailing Address - Fax:360-956-3903
Practice Address - Street 1:911 5TH AVE SE
Practice Address - Street 2:SUITE 202
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1534
Practice Address - Country:US
Practice Address - Phone:360-956-3900
Practice Address - Fax:360-956-3903
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8854554Medicare PIN
WAV92078Medicare UPIN