Organization
35TH AVENUE CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC RYAN LOBERG D.C. (OWNER AND CHIROPRACTOR)
(206) 932-8320
Entity
Organization
Contact information
Practice address
9455 35TH AVE SW, SUITE E, SEATTLE, WA 98126-3898
(206) 932-8320
(206) 932-6941
Mailing address
9455 35TH AVE SW, SUITE E, SEATTLE, WA 98126-3898
(206) 932-8320
(206) 932-6941
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034106
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0163578
LABOR & INDUSTRIES
WA
01
—
1225012768
INDIVIDUAL NPI
WA
01
—
1457490542
GROUP NPI
WA
01
—
5711LO
REGENCE BLUE SHIELD
WA
01
—
614143800
OWCP
WA
Enumeration date
02/05/2007
Last updated
07/01/2010
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