Organization
AVANT CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SHANE MACKINNON DC (OWNER)
(206) 826-1005
Entity
Organization
Contact information
Practice address
3611 WOODLAND PARK AVE N, SEATTLE, WA 98103-7905
(206) 826-1005
(206) 826-1289
Mailing address
3611 WOODLAND PARK AVE N, SEATTLE, WA 98103-7905
(206) 826-1005
(206) 826-1289
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00033810
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0173323
LABOR & INDUSTRIES
WA
Enumeration date
07/17/2007
Last updated
07/17/2007
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