Provider Demographics
NPI:1134339658
Name:ALPINE CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:ALPINE CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:A
Authorized Official - Last Name:PFIFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-888-6846
Mailing Address - Street 1:PO BOX 2388
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-2388
Mailing Address - Country:US
Mailing Address - Phone:425-888-6846
Mailing Address - Fax:425-888-6932
Practice Address - Street 1:118 DOWNING AVE N
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8301
Practice Address - Country:US
Practice Address - Phone:425-888-6846
Practice Address - Fax:425-888-6932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA05-000054.0111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA69414Medicare PIN
WAG69414Medicare PIN