Provider Demographics
NPI:1801250311
Name:SUNCREST CHIROPRACTIC PS
Entity type:Organization
Organization Name:SUNCREST CHIROPRACTIC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAUVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-994-3969
Mailing Address - Street 1:PO BOX 30756
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-3012
Mailing Address - Country:US
Mailing Address - Phone:509-994-3969
Mailing Address - Fax:
Practice Address - Street 1:5978 HIGHWAY 291
Practice Address - Street 2:UNIT #2
Practice Address - City:NINE MILE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99026-5002
Practice Address - Country:US
Practice Address - Phone:509-994-3969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60126765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty