Provider Demographics
NPI:1932123304
Name:SOWERS, BURTON ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:ALLAN
Last Name:SOWERS
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 1:3015 LIMITED LN NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-2638
Mailing Address - Country:US
Mailing Address - Phone:360-357-7113
Mailing Address - Fax:360-357-5946
Practice Address - Street 1:3015 LIMITED LN NW
Practice Address - Street 2:SUITE A
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-2638
Practice Address - Country:US
Practice Address - Phone:360-357-7113
Practice Address - Fax:360-357-5946
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2031813Medicaid
WAU52386Medicare UPIN
WAG115000374Medicare PIN