Individual
DR. JOHN BRUCE PERMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
260 BAY LYN DR, LYNDEN, WA 98264-9464
(360) 354-6800
Mailing address
260 BAY LYN DR, LYNDEN, WA 98264-9405
(360) 354-6800
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001920
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6020
DEPT. OF LABOR & INDUST
WA
01
—
653559
ACN
WA
01
—
G8806685
MEDICARE ID-TYPE UNSPECIFIED
WA
Enumeration date
09/26/2006
Last updated
09/26/2016
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