Provider Demographics
NPI:1144491697
Name:REEDER CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:REEDER CHIROPRACTIC CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:REEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-821-1900
Mailing Address - Street 1:9750 NE 120TH PL STE 2
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4207
Mailing Address - Country:US
Mailing Address - Phone:425-821-1900
Mailing Address - Fax:425-820-1802
Practice Address - Street 1:9750 NE 120TH PL STE 2
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4207
Practice Address - Country:US
Practice Address - Phone:425-821-1900
Practice Address - Fax:425-820-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE 1199OtherREGENCE
T01791Medicare UPIN
WAG88569521Medicare PIN