Provider Demographics
NPI:1811945181
Name:RINDAL, JEFFREY FRANK (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:FRANK
Last Name:RINDAL
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 1:21368 BULSON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-9543
Mailing Address - Country:US
Mailing Address - Phone:360-424-8115
Mailing Address - Fax:360-428-0104
Practice Address - Street 1:1601 WILLIAM WAY
Practice Address - Street 2:STE A
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2500
Practice Address - Country:US
Practice Address - Phone:360-424-8115
Practice Address - Fax:360-428-0104
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8860445Medicare PIN