Provider Demographics
NPI:1801889951
Name:ESTABROOK, LEW C (DC)
Entity type:Individual
Prefix:DR
First Name:LEW
Middle Name:C
Last Name:ESTABROOK
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 1:13030 121ST WAY NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7210
Mailing Address - Country:US
Mailing Address - Phone:425-814-2800
Mailing Address - Fax:425-823-0882
Practice Address - Street 1:13030 121ST WAY NE
Practice Address - Street 2:SUITE 102
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7210
Practice Address - Country:US
Practice Address - Phone:425-814-2800
Practice Address - Fax:425-823-0882
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001963111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2004943Medicaid
WA0004151OtherLABOR & INDUSTRIES
ES2561OtherREGENCE BLUE SHIELD
350015397OtherRAILROAD MEDICARE
GAB09918Medicare ID - Type Unspecified