Provider Demographics
NPI:1801950266
Name:BALL, STEPHEN WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:BALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1717 S 324TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8500
Mailing Address - Country:US
Mailing Address - Phone:253-838-6909
Mailing Address - Fax:253-661-3610
Practice Address - Street 1:1717 S 324TH ST STE B
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8500
Practice Address - Country:US
Practice Address - Phone:253-838-6909
Practice Address - Fax:253-661-3610
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB03577Medicare ID - Type Unspecified
WAU70038Medicare UPIN