Provider Demographics
NPI:1285070789
Name:CALLAHAN, ABIGAIL (DC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25412 62ND AVE S APT BB201
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-4975
Mailing Address - Country:US
Mailing Address - Phone:760-216-9974
Mailing Address - Fax:
Practice Address - Street 1:25412 62ND AVE S APT BB201
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-4975
Practice Address - Country:US
Practice Address - Phone:760-216-9974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-12
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60895924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor