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Organization

EAGLE HARBOR CHIROPRACTIC INC.P.S.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIRK W PETHERAM D.C. (OWNER)
(206) 842-2702
Entity
Organization

Contact information

Practice address
748 WINSLOW WAY E, BAINBRIDGE ISLAND, WA 98110-2410
(206) 842-2702
Mailing address
748 WINSLOW WAY E, BAINBRIDGE ISLAND, WA 98110-2410
(206) 842-2702

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
22433
CA
111N00000X
Chiropractor
22670
CA
111N00000X
Chiropractor
Primary
3554
WA
111N00000X
Chiropractor
3595
WA
225700000X
Massage Therapist
MA00014485
WA
225700000X
Massage Therapist
MA00019967
WA

Other

Enumeration date
03/07/2007
Last updated
12/05/2007
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