Provider Demographics
NPI:1801937974
Name:W.C.C.P.S.
Entity type:Organization
Organization Name:W.C.C.P.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RANK
Authorized Official - Last Name:BATY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-524-5444
Mailing Address - Street 1:2817 NE 55TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5529
Mailing Address - Country:US
Mailing Address - Phone:206-524-5444
Mailing Address - Fax:206-524-0709
Practice Address - Street 1:2817 NE 55TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5529
Practice Address - Country:US
Practice Address - Phone:206-524-5444
Practice Address - Fax:206-524-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5871WWOtherREGENCE BLUE SHIELD
WA15081OtherLABOR & INDUSTRIES