Provider Demographics
NPI:1881802114
Name:LAWHEAD, J F (DC)
Entity type:Individual
Prefix:
First Name:J
Middle Name:F
Last Name:LAWHEAD
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 1:108 E INDIANA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2316
Mailing Address - Country:US
Mailing Address - Phone:509-328-3344
Mailing Address - Fax:509-328-3644
Practice Address - Street 1:108 E INDIANA AVE
Practice Address - Street 2:STE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2316
Practice Address - Country:US
Practice Address - Phone:509-328-3344
Practice Address - Fax:509-328-3644
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0001501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2060101Medicaid
WA17004OtherLABOR AND INDUSTRIES
WA2060101Medicaid
WAT02514Medicare UPIN