Provider Demographics
NPI:1831244599
Name:SHERWOOD, KURT (DC)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:SHERWOOD
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 1:16810 108TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5413
Mailing Address - Country:US
Mailing Address - Phone:425-227-0111
Mailing Address - Fax:425-228-2583
Practice Address - Street 1:16810 108TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5413
Practice Address - Country:US
Practice Address - Phone:425-227-0111
Practice Address - Fax:425-228-2583
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU11478Medicare UPIN