Provider Demographics
NPI:1952708604
Name:GUILLEMETTE, ERIC ARMAND (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ARMAND
Last Name:GUILLEMETTE
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 1:22312 MARINE VIEW DR S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6832
Mailing Address - Country:US
Mailing Address - Phone:206-824-8464
Mailing Address - Fax:206-824-8470
Practice Address - Street 1:22312 MARINE VIEW DR S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6832
Practice Address - Country:US
Practice Address - Phone:206-824-8464
Practice Address - Fax:206-824-8470
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60509267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor