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Organization

NORTHWEST FAMILY CHIROPRACTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY LYNN HOLMES D.C. (DOCTOR OF CHIROPRACTIC)
(253) 848-6603
Entity
Organization

Contact information

Practice address
17615 85TH AVENUE CT E, PUYALLUP, WA 98375-1859
(253) 848-6603
(253) 445-9430
Mailing address
17615 85TH AVENUE CT E, PUYALLUP, WA 98375-1859
(253) 848-6603
(253) 445-9430

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2705
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2705
WA CHIRO LICENSE
WA
01
350050140
RAILROAD MEDICARE
WA
01
601879408
WA UBI#
WA
01
H04731
REGENCE
WA
01
LNI
LNI PROVIDER #
WA
Enumeration date
01/23/2007
Last updated
05/07/2018
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