Provider Demographics
NPI:1316137839
Name:HEMPHILL CHIROPRACTIC CLINIC, P.S.
Entity type:Organization
Organization Name:HEMPHILL CHIROPRACTIC CLINIC, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:KARRIEM
Authorized Official - Last Name:HEMPHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-214-1900
Mailing Address - Street 1:18421 HIGHWAY 99
Mailing Address - Street 2:STE G
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4457
Mailing Address - Country:US
Mailing Address - Phone:425-214-1900
Mailing Address - Fax:425-214-1919
Practice Address - Street 1:18421 HIGHWAY 99
Practice Address - Street 2:STE G
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4457
Practice Address - Country:US
Practice Address - Phone:425-214-1900
Practice Address - Fax:425-214-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034117261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2028470Medicaid
WA1275699506OtherNPI
WA173024OtherLABOR & INDUSTRIES
WAU96368Medicare UPIN
WA2028470Medicaid