Individual
DR. LARRY A BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
7612 NE HAZEL DELL AVE, VANCOUVER, WA 98665
(360) 694-1575
(360) 696-4427
Mailing address
7612 N.E. HAZEL DELL AVE, VANCOUVER, WA 98665
(360) 694-1575
(360) 696-4427
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00000783
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17047
OR STATE PAYEE # (L&I)
OR
05
—
2041507
—
WA
01
—
75953
WA STATE PAYEE # (L&I)
WA
Enumeration date
02/24/2006
Last updated
02/17/2012
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