Provider Demographics
NPI:1881691822
Name:STEFFEN, TED ROBERT (DC)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:ROBERT
Last Name:STEFFEN
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 1:235 WESTLAKE AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5217
Mailing Address - Country:US
Mailing Address - Phone:206-245-9637
Mailing Address - Fax:
Practice Address - Street 1:235 WESTLAKE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5217
Practice Address - Country:US
Practice Address - Phone:206-749-5253
Practice Address - Fax:206-749-4049
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83952Medicare UPIN
AB19655Medicare ID - Type Unspecified