Provider Demographics
NPI:1487308367
Name:CONTRIS, JAMES VLADIMIR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VLADIMIR
Last Name:CONTRIS
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 1:504 W ST SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5330
Mailing Address - Country:US
Mailing Address - Phone:360-688-8666
Mailing Address - Fax:
Practice Address - Street 1:4631 WHITMAN LN SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98513-2234
Practice Address - Country:US
Practice Address - Phone:360-923-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH612660528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor