Provider Demographics
NPI:1831788918
Name:FRIEDMAN CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:FRIEDMAN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-432-4451
Mailing Address - Street 1:17007 SE 261ST ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-8373
Mailing Address - Country:US
Mailing Address - Phone:253-278-8549
Mailing Address - Fax:
Practice Address - Street 1:11511 CANTERWOOD BLVD. NW
Practice Address - Street 2:SUITE #210
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5818
Practice Address - Country:US
Practice Address - Phone:253-432-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty