Provider Demographics
NPI:1972742211
Name:GREENWOOD CHIROPRACTIC CLINIC, INC PS
Entity type:Organization
Organization Name:GREENWOOD CHIROPRACTIC CLINIC, INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FEIROUZ
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARSHEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-784-9806
Mailing Address - Street 1:8537 PHINNEY AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-3705
Mailing Address - Country:US
Mailing Address - Phone:206-784-9806
Mailing Address - Fax:206-789-6312
Practice Address - Street 1:8537 PHINNEY AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3705
Practice Address - Country:US
Practice Address - Phone:206-784-9806
Practice Address - Fax:206-789-6312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000100188Medicare UPIN