Organization
PINE LAKE CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID EMIL BAHM D.C. (PRESIDENT)
(425) 391-4095
Entity
Organization
Contact information
Practice address
2908 228TH AVE SE, SUITE C, SAMMAMISH, WA 98075-9306
(425) 391-4095
(425) 391-6059
Mailing address
2908 228TH AVE SE, SUITE C, SAMMAMISH, WA 98075-9306
(425) 391-4095
(425) 391-6059
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00002143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038178
L AND I
WA
01
—
1356433726
DAVID BAHM NPI
WA
05
—
2032670
—
WA
Enumeration date
04/02/2007
Last updated
08/22/2020
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