Provider Demographics
NPI:1215097977
Name:SWEET, DENNIS C (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:SWEET
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 1:12919 WOODLAND AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-6303
Mailing Address - Country:US
Mailing Address - Phone:253-770-4048
Mailing Address - Fax:
Practice Address - Street 1:8905 GRAVELLY LAKE DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3109
Practice Address - Country:US
Practice Address - Phone:253-581-1533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002765111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU39642Medicare UPIN
WAG001002477Medicare ID - Type Unspecified