Provider Demographics
NPI:1770703639
Name:PEARSON, RICHARD W (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:PEARSON
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 1:7922 N PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-8869
Mailing Address - Country:US
Mailing Address - Phone:509-466-7654
Mailing Address - Fax:509-466-7654
Practice Address - Street 1:7922 N PANORAMA DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8869
Practice Address - Country:US
Practice Address - Phone:509-466-7654
Practice Address - Fax:509-466-7654
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG000301208OtherMEDICARE PTAN