Organization
FERNDALE CHIROPRACTIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERRE R CONSTANTIN DC (OWNER)
(360) 319-3485
Entity
Organization
Contact information
Practice address
2376 MAIN ST STE 1, FERNDALE, WA 98248-8605
(360) 312-4656
(360) 392-8732
Mailing address
PO BOX 1256, FERNDALE, WA 98248-1256
(360) 312-4656
(360) 392-8732
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0001782
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063990000
REGENCE BLUESHIELD
WA
05
—
2091205
—
WA
01
—
456782001
GROUP HEALTH
WA
Enumeration date
05/03/2016
Last updated
07/10/2019
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