Provider Demographics
NPI:1427119411
Name:DACHOWSKI, JESSICA JO (DC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JO
Last Name:DACHOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 EAST 36TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-764-1391
Mailing Address - Fax:907-562-3061
Practice Address - Street 1:600 EAST 36TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-764-1391
Practice Address - Fax:907-562-3061
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH5182Medicaid