Organization
TWIN LAKES CHIROPRACTIC, INC. P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA DALE HANSEN (QWNER)
(253) 838-3777
Entity
Organization
Contact information
Practice address
1107 S 347TH PL, FEDERAL WAY, WA 98003-6718
(253) 838-3777
(253) 874-6874
Mailing address
1107 S 347TH PL, FEDERAL WAY, WA 98003-6718
(253) 838-3777
(253) 874-6874
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108635
WORKERS COMPENSATION
WA
Enumeration date
12/27/2006
Last updated
08/22/2020
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