Provider Demographics
NPI:1306990460
Name:POWERS, MITCHELL (DC)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:
Last Name:POWERS
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 1:10501 NE HIGHWAY 99
Mailing Address - Street 2:SUITE 23
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-5697
Mailing Address - Country:US
Mailing Address - Phone:360-896-5918
Mailing Address - Fax:360-896-5302
Practice Address - Street 1:10501 NE HIGHWAY 99
Practice Address - Street 2:SUITE 23
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-5697
Practice Address - Country:US
Practice Address - Phone:360-896-5918
Practice Address - Fax:360-896-5302
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002709111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician