Individual
DR. KENNETH EUGENE ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
365 H ST, BLAINE, WA 98230-4109
(360) 332-4730
(360) 332-3309
Mailing address
399 H ST, STE 2, BLAINE, WA 98230-4100
(360) 332-4730
(360) 332-3309
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1485
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1668403003
CIGNA PAL
WA
01
—
2065308
DSHS
WA
01
—
34345
DEPT. OF LABOR & INDUST.
WA
01
—
350019617
PALMETTO RAIL MED.
WA
01
—
360320000
BCBS
WA
01
—
7785313
AETNA
WA
01
—
91-1218101
FED EMP. ID #
WA
Enumeration date
01/23/2007
Last updated
10/04/2016
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