Organization
FAIRWOOD CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN THOMAS RYAN DC (OWNER)
(425) 226-1856
Entity
Organization
Contact information
Practice address
14410 SE PETROVITSKY RD, STE 109, RENTON, WA 98058-8900
(425) 226-1856
(425) 226-0231
Mailing address
14410 SE PETROVITSKY RD, STE 109, RENTON, WA 98058-8900
(425) 226-1856
(425) 226-0231
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00001828
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122123
WA ST L & I
WA
01
—
P00070121
RAILROAD MEDICARE
—
Enumeration date
04/16/2007
Last updated
06/24/2008
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