Individual
DR. GREGORY TODD LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
13800 NE 20TH AVE, VANCOUVER, WA 98686-2704
(360) 574-5944
(360) 574-6430
Mailing address
2625 BUTTERFIELD RD STE 301N, OAK BROOK, IL 60523-1266
(630) 468-1824
(630) 468-1478
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034332
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122681300
FEDERAL L & I
WA
01
—
184778
STATE L & I
WA
Enumeration date
07/15/2006
Last updated
12/16/2020
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