Provider Demographics
NPI:1194802801
Name:WALDROP, JEFFRY (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:
Last Name:WALDROP
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 1:11314 4TH AVE W
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6926
Mailing Address - Country:US
Mailing Address - Phone:425-355-3739
Mailing Address - Fax:
Practice Address - Street 1:11314 4TH AVE W
Practice Address - Street 2:SUITE 103
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6926
Practice Address - Country:US
Practice Address - Phone:425-355-3739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2521111NS0005X
WA60289583111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician