Provider Demographics
NPI:1770979783
Name:CONSCIOUS CHOICE CHIROPRACTIC
Entity type:Organization
Organization Name:CONSCIOUS CHOICE CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-267-7000
Mailing Address - Street 1:6415 FAUNTLEROY WAY SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1871
Mailing Address - Country:US
Mailing Address - Phone:206-267-7000
Mailing Address - Fax:206-938-4219
Practice Address - Street 1:6415 FAUNTLEROY WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1871
Practice Address - Country:US
Practice Address - Phone:206-267-7000
Practice Address - Fax:206-938-4219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSCIOUS CHOICE CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034182302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization