Provider Demographics
NPI:1811963010
Name:HARRELL, WILLIAM C (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:HARRELL
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:PO BOX 4339
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-0339
Mailing Address - Country:US
Mailing Address - Phone:360-489-0635
Mailing Address - Fax:360-489-0917
Practice Address - Street 1:509 CUSTER WAY SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-3332
Practice Address - Country:US
Practice Address - Phone:360-489-0635
Practice Address - Fax:360-489-0917
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor