Provider Demographics
NPI:1982166682
Name:ECKROTH, WILHELM BRUNO VON
Entity Type:Individual
Prefix:
First Name:WILHELM
Middle Name:BRUNO VON
Last Name:ECKROTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3541
Mailing Address - Country:US
Mailing Address - Phone:262-442-0327
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST STE 110
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3541
Practice Address - Country:US
Practice Address - Phone:425-636-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH.60944552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor