Provider Demographics
NPI:1750656302
Name:SEQUIM CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:SEQUIM CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNDSAY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MISHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-683-8844
Mailing Address - Street 1:625 N 5TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-5062
Mailing Address - Country:US
Mailing Address - Phone:360-683-8844
Mailing Address - Fax:
Practice Address - Street 1:625 N 5TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-5062
Practice Address - Country:US
Practice Address - Phone:360-683-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60196521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty