Provider Demographics
NPI:1720283658
Name:JAMES A WELLS INC PS
Entity type:Organization
Organization Name:JAMES A WELLS INC PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-428-0471
Mailing Address - Street 1:17226 SR 536
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-8757
Mailing Address - Country:US
Mailing Address - Phone:360-428-0471
Mailing Address - Fax:360-428-0435
Practice Address - Street 1:17226 SR 536
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-8757
Practice Address - Country:US
Practice Address - Phone:360-428-0471
Practice Address - Fax:360-428-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2086809Medicaid
T02916Medicare UPIN
WA2086809Medicaid