Provider Demographics
NPI:1043449382
Name:ALLAN R. MCCORD PS
Entity type:Organization
Organization Name:ALLAN R. MCCORD PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-854-3040
Mailing Address - Street 1:10830 SE KENT KANGLEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-9011
Mailing Address - Country:US
Mailing Address - Phone:253-854-3040
Mailing Address - Fax:253-854-3821
Practice Address - Street 1:10830 SE KENT KANGLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-9011
Practice Address - Country:US
Practice Address - Phone:253-854-3040
Practice Address - Fax:253-854-3821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA101697OtherWASHINGTON STATE DEPT. OF LABOR AND INDUSTRIES
WAMC3700OtherREGENCE BLUESHIELD
WA7601345OtherCIGNA