Provider Demographics
NPI:1235311895
Name:ESSENTIAL CHIROPRACTIC AND ASSOCIATES INC
Entity type:Organization
Organization Name:ESSENTIAL CHIROPRACTIC AND ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-688-0223
Mailing Address - Street 1:1050 140TH AVE NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2972
Mailing Address - Country:US
Mailing Address - Phone:425-688-0223
Mailing Address - Fax:425-688-0323
Practice Address - Street 1:1050 140TH AVE NE
Practice Address - Street 2:SUITE D
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2972
Practice Address - Country:US
Practice Address - Phone:425-688-0223
Practice Address - Fax:425-688-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33822111N00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8870228Medicare PIN