Organization
DR JUSTIN J FAVREAU PLLC
Active
Other names
Stability Spine & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN JOHN FAVREAU D.C. (PRESIDENT/CLINIC DIRECTOR)
(206) 497-4962
Entity
Organization
Contact information
Practice address
1225 DEXTER AVE N, SEATTLE, WA 98109-3518
(206) 497-4962
(206) 316-8655
Mailing address
1225 DEXTER AVE N, SEATTLE, WA 98109-3518
(206) 497-4962
(206) 316-8655
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034786
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0261812
LABOR AND INDUSTRIES - INDIVIDUAL
WA
01
—
0268936
LABOR AND INDUSTRIES - GROUP
WA
01
—
1023194339
INDIVIDUAL NPI
—
01
—
8870884
MEDICARE PTAN
WA
Enumeration date
10/25/2011
Last updated
05/29/2013
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