Provider Demographics
NPI:1538753298
Name:ONE HEALTH SPINE AND INJURY CENTER
Entity type:Organization
Organization Name:ONE HEALTH SPINE AND INJURY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-285-9304
Mailing Address - Street 1:P.O BOX 50187
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015
Mailing Address - Country:US
Mailing Address - Phone:425-285-9304
Mailing Address - Fax:425-996-9531
Practice Address - Street 1:3640 S CEDAR ST, STE P
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409
Practice Address - Country:US
Practice Address - Phone:425-285-9304
Practice Address - Fax:425-996-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1396902508OtherCHIROPRACTOR