Provider Demographics
NPI:1780995522
Name:KREIDER, DAVID ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:KREIDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1750 112TH AVE NE
Mailing Address - Street 2:SUITE B210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3752
Mailing Address - Country:US
Mailing Address - Phone:425-467-6633
Mailing Address - Fax:425-455-8914
Practice Address - Street 1:1750 112TH AVE NE
Practice Address - Street 2:SUITE B210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3752
Practice Address - Country:US
Practice Address - Phone:425-467-6633
Practice Address - Fax:425-455-8914
Is Sole Proprietor?:No
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603021969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor