Provider Demographics
NPI:1104825686
Name:ERNST, LOREN CARY (DC)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:CARY
Last Name:ERNST
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 1:16714 SMOKEY POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223
Mailing Address - Country:US
Mailing Address - Phone:360-659-8464
Mailing Address - Fax:360-659-3044
Practice Address - Street 1:16714 SMOKEY POINT BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-659-8464
Practice Address - Fax:360-659-3044
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2010-11-10
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2007-03-30
Provider Licenses
StateLicense IDTaxonomies
WA2486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA001250702Medicare ID - Type Unspecified
O21717Medicare UPIN