Provider Demographics
NPI:1538369095
Name:NATURALLY CHIROPRACTIC FAMILY WELLNESS CENTER INC
Entity type:Organization
Organization Name:NATURALLY CHIROPRACTIC FAMILY WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-334-6258
Mailing Address - Street 1:9327 4TH ST NE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-1630
Mailing Address - Country:US
Mailing Address - Phone:425-334-6258
Mailing Address - Fax:425-334-1187
Practice Address - Street 1:9327 4TH ST NE
Practice Address - Street 2:SUITE 6
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-1630
Practice Address - Country:US
Practice Address - Phone:425-334-6258
Practice Address - Fax:425-334-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602146175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2026151Medicaid
WAAB26351Medicare PIN