Provider Demographics
NPI:1538224316
Name:ATKINS, PETER R (DC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:R
Last Name:ATKINS
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 1:2621 70TH AVE W STE A
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5459
Mailing Address - Country:US
Mailing Address - Phone:253-752-7522
Mailing Address - Fax:
Practice Address - Street 1:2621 70TH AVE W STE A
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-5459
Practice Address - Country:US
Practice Address - Phone:253-752-7522
Practice Address - Fax:253-759-3552
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor