Provider Demographics
NPI:1528533668
Name:SPITZ, KIRSTEN LYNN (DC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LYNN
Last Name:SPITZ
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 1:1815 126TH DR SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-9203
Mailing Address - Country:US
Mailing Address - Phone:425-359-8896
Mailing Address - Fax:
Practice Address - Street 1:24016 BOTHELL EVERETT HWY # B200
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9361
Practice Address - Country:US
Practice Address - Phone:971-213-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60895753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor