Provider Demographics
NPI:1881705002
Name:PARTAIN, TODD LEE (DC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:LEE
Last Name:PARTAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23870 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6848
Mailing Address - Country:US
Mailing Address - Phone:425-413-1718
Mailing Address - Fax:425-413-1035
Practice Address - Street 1:23870 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-6848
Practice Address - Country:US
Practice Address - Phone:425-413-1718
Practice Address - Fax:425-413-1718
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB07517Medicare ID - Type Unspecified