Individual
KRISTOPHER MARTIN LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
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
04/18/2014
Last updated
10/29/2014
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