Provider Demographics
NPI:1780455196
Name:CROSS, HUXLEY RIAN (DC)
Entity type:Individual
Prefix:
First Name:HUXLEY
Middle Name:RIAN
Last Name:CROSS
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 1:7816 147TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-2503
Mailing Address - Country:US
Mailing Address - Phone:253-985-0018
Mailing Address - Fax:
Practice Address - Street 1:4329 A ST SE UNIT F
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-8618
Practice Address - Country:US
Practice Address - Phone:253-929-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61514808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor