Provider Demographics
NPI:1871518738
Name:CHOSEN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CHOSEN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-455-5444
Mailing Address - Street 1:606 120TH AVE NE
Mailing Address - Street 2:D104
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-455-5444
Mailing Address - Fax:425-646-8047
Practice Address - Street 1:606 120TH AVE NE
Practice Address - Street 2:D104
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005
Practice Address - Country:US
Practice Address - Phone:425-455-5444
Practice Address - Fax:425-646-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA121358OtherL & I
AB04109Medicare ID - Type Unspecified