Provider Demographics
NPI:1366478067
Name:CHEPLE, CRAIG ERNEST (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ERNEST
Last Name:CHEPLE
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 1:400 COOPER POINT RD SW
Mailing Address - Street 2:SUITE #4
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8705
Mailing Address - Country:US
Mailing Address - Phone:360-943-2358
Mailing Address - Fax:360-943-2358
Practice Address - Street 1:400 COOPER POINT RD SW
Practice Address - Street 2:SUITE #4
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8705
Practice Address - Country:US
Practice Address - Phone:360-943-2358
Practice Address - Fax:360-943-2358
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA131546OtherDLI
WA2003119Medicaid
WACH4218OtherBCI
WATO2835Medicare UPIN