Provider Demographics
NPI:1346791159
Name:CARLILE, JOSHUA ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ROBERT
Last Name:CARLILE
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 1:9621 MICKELBERRY RD NW
Mailing Address - Street 2:STE 108
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8301
Mailing Address - Country:US
Mailing Address - Phone:360-692-5350
Mailing Address - Fax:360-692-5354
Practice Address - Street 1:9621 MICKELBERRY RD NW STE 108
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8301
Practice Address - Country:US
Practice Address - Phone:360-692-5350
Practice Address - Fax:360-692-5354
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1045111N00000X
AZ8510111N00000X
AZ5123111N00000X
WA60651990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor