Individual
DAVID MARK WASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1415 US HWY 16, LACROSSE, WI 54601
(608) 785-7746
(608) 782-2938
Mailing address
1415 US HWY 16, LACROSSE, WI 54601
(608) 785-7746
(608) 782-2938
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2535
WI
111NS0005X
Sports Physician Chiropractor
2813
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279J7WA
BLUE CROSS BLUE SHIELD
MN
01
—
391762498
FED TAX
WI
01
—
391762498015
BLUE CROSS BLUE SHIELD
WI
01
—
P00046865
RAILROAD MEDICARE
—
Enumeration date
12/04/2006
Last updated
05/22/2008
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