Organization
PACIFIC CHIROPRACTIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN THOMAS O'HEA D.C. (OWNER)
(425) 775-8000
Entity
Organization
Contact information
Practice address
7503 196TH ST SW, LYNNWOOD, WA 98036-5079
(425) 775-8000
(425) 775-8221
Mailing address
7503 196TH ST SW, LYNNWOOD, WA 98036-5079
(425) 775-8000
(425) 775-8221
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12905
AWHN
WA
01
—
13665
AWHN
WA
01
—
72790
DEPT OF LABOR
WA
01
—
R21556
REGENCE BLUE SHIELD
WA
01
—
R74350
REGENCE BLUE SHIELD
WA
Enumeration date
02/19/2007
Last updated
10/24/2007
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