Individual
DR. MICHAEL B BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
11802 NE 65TH ST, SUITE 100, VANCOUVER, WA 98662-5521
(360) 253-6883
(360) 892-7040
Mailing address
11802 NE 65TH ST, SUITE 100, VANCOUVER, WA 98662-5521
(360) 253-6883
(360) 892-7040
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00002774
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0187146
DEPT OF LABOR & INDS.
WA
05
—
84058466
—
WA
01
—
P00169111
MEDICARE RAILROAD
WA
Enumeration date
06/15/2005
Last updated
02/19/2008
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