Provider Demographics
NPI:1306966551
Name:JASON N PRIGGE, DC PLLC
Entity type:Organization
Organization Name:JASON N PRIGGE, DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:NEWMAN
Authorized Official - Last Name:PRIGGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-943-4919
Mailing Address - Street 1:604 WILLIAMS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3207
Mailing Address - Country:US
Mailing Address - Phone:509-943-4919
Mailing Address - Fax:509-946-0632
Practice Address - Street 1:604 WILLIAMS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3207
Practice Address - Country:US
Practice Address - Phone:509-943-4919
Practice Address - Fax:509-946-0632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8859190Medicare PIN
U75107Medicare UPIN