Organization
KENT CHIROPRACTIC CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON RAYMOND KENT DC (CHIROPRACTOR)
(360) 642-4390
Entity
Organization
Contact information
Practice address
4403 PACIFIC HIGHWAY, SEAVIEW, WA 98644-0004
(360) 642-4390
Mailing address
PO BOX D, SEAVIEW, WA 98644-0004
(360) 642-4390
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
025202
WA
111N00000X
Chiropractor
Primary
CH00001614
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017594
L & I
WA
Enumeration date
02/02/2007
Last updated
12/07/2007
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