Provider Demographics
NPI:1427156058
Name:HOYT, KEITH O (DC, CCEP)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:O
Last Name:HOYT
Suffix:
Gender:M
Credentials:DC, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14823 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3281
Mailing Address - Country:US
Mailing Address - Phone:360-428-3669
Mailing Address - Fax:
Practice Address - Street 1:14823 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3281
Practice Address - Country:US
Practice Address - Phone:360-428-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOOO1907111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA95425OtherLI PROVIDER NUMBER