Provider Demographics
NPI:1447509070
Name:ATCHISON, MIRINDA (DC)
Entity type:Individual
Prefix:
First Name:MIRINDA
Middle Name:
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 BICKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1743
Mailing Address - Country:US
Mailing Address - Phone:425-328-8370
Mailing Address - Fax:
Practice Address - Street 1:1820 BICKFORD AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1743
Practice Address - Country:US
Practice Address - Phone:425-328-8370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60297612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor