Organization
EDMONDS-WOODWAY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER MARTY LANE DC (OWNER)
(903) 742-1072
Entity
Organization
Contact information
Practice address
7631 212TH ST SW, 105B, EDMONDS, WA 98026-7565
(903) 742-1072
(425) 775-9608
Mailing address
7631 212TH ST SW, 105B, EDMONDS, WA 98026-7565
(903) 742-1072
(425) 775-9608
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH60443467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0325925
LABOR AND INDUSTRIES
WA
Enumeration date
10/29/2014
Last updated
03/04/2015
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