Provider Demographics
NPI:1699965921
Name:GATEWAY CHIROPRACTIC, INC.,P.S.
Entity type:Organization
Organization Name:GATEWAY CHIROPRACTIC, INC.,P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:ORVILLE
Authorized Official - Last Name:BIERL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-855-1504
Mailing Address - Street 1:919 METCALF ST
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1501
Mailing Address - Country:US
Mailing Address - Phone:360-855-1504
Mailing Address - Fax:
Practice Address - Street 1:919 METCALF ST
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1501
Practice Address - Country:US
Practice Address - Phone:360-855-1504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT92384Medicare UPIN