Individual
DR. JUSTIN JOHN FAVREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1225 DEXTER AVE NORTH, SEATTLE, WA 98109
(206) 497-4962
(206) 316-8655
Mailing address
1225 DEXTER AVE NORTH, SEATTLE, WA 98109
(206) 497-4962
(206) 316-8655
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
6129
CO
111N00000X
Chiropractor
Primary
CH00034786
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8870884
NORIDIAN MEDICARE PTAN
WA
Enumeration date
10/29/2006
Last updated
03/13/2014
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