Provider Demographics
NPI:1588704506
Name:MEYER SMITH, DANA COLLEEN (DC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:COLLEEN
Last Name:MEYER SMITH
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 1:2410 YEW ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-3940
Mailing Address - Country:US
Mailing Address - Phone:360-733-4222
Mailing Address - Fax:360-733-6433
Practice Address - Street 1:2410 YEW ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-3940
Practice Address - Country:US
Practice Address - Phone:360-733-4222
Practice Address - Fax:360-733-6433
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB35561OtherMEDICARE ID-PIN