Provider Demographics
NPI:1699117713
Name:HANNAHS CHIROPRACTIC CORP PS
Entity type:Organization
Organization Name:HANNAHS CHIROPRACTIC CORP PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNAHS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-726-6095
Mailing Address - Street 1:13317 NE 12TH AVE
Mailing Address - Street 2:115
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2727
Mailing Address - Country:US
Mailing Address - Phone:360-726-6095
Mailing Address - Fax:360-326-4025
Practice Address - Street 1:13317 NE 12TH AVE.
Practice Address - Street 2:115
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2731
Practice Address - Country:US
Practice Address - Phone:360-726-6095
Practice Address - Fax:360-326-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60021341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty