Organization
BOTHELL CHIROPRACTIC & WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTY D DUBOIS D.C. (MEMBER)
(425) 485-1413
Entity
Organization
Contact information
Practice address
10024 MAIN ST, SUITE 2-C, BOTHELL, WA 98011-3424
(425) 485-1413
Mailing address
PO BOX 1286, BOTHELL, WA 98041-1286
(425) 485-1413
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
3632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235137639
INDIVIDUAL NPI NUMBER
WA
01
—
125930
L&I PROVIDER NUMBER
WA
01
—
350056758
RR MEDICARE
WA
01
—
AB10961
MEDICARE
—
Enumeration date
05/12/2008
Last updated
08/24/2009
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