Provider Demographics
NPI:1912136904
Name:SANDERSON CHIROPRACTIC CARE PLLC
Entity type:Organization
Organization Name:SANDERSON CHIROPRACTIC CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-847-7517
Mailing Address - Street 1:22811 MERIDIAN AVE E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-9275
Mailing Address - Country:US
Mailing Address - Phone:253-847-7517
Mailing Address - Fax:253-847-7467
Practice Address - Street 1:22811 MERIDIAN AVE E
Practice Address - Street 2:SUITE 2
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-9275
Practice Address - Country:US
Practice Address - Phone:253-847-7517
Practice Address - Fax:253-847-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1162261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service