Provider Demographics
NPI:1881997997
Name:ASCENSION CHIROPRACTIC AND WELLNESS CENTER P.S. INC
Entity type:Organization
Organization Name:ASCENSION CHIROPRACTIC AND WELLNESS CENTER P.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-546-2205
Mailing Address - Street 1:18820 AURORA AVE N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3900
Mailing Address - Country:US
Mailing Address - Phone:206-546-2205
Mailing Address - Fax:206-533-6214
Practice Address - Street 1:18820 AURORA AVE N
Practice Address - Street 2:SUITE 102
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3900
Practice Address - Country:US
Practice Address - Phone:206-546-2205
Practice Address - Fax:206-533-6214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60020387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty