Provider Demographics
NPI:1548025505
Name:MICHAEL J ENSTAD, DC, PLLC
Entity type:Organization
Organization Name:MICHAEL J ENSTAD, DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ENSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-472-2225
Mailing Address - Street 1:7247 S PINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-5900
Mailing Address - Country:US
Mailing Address - Phone:253-472-2225
Mailing Address - Fax:253-474-9596
Practice Address - Street 1:7247 S PINE ST STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5900
Practice Address - Country:US
Practice Address - Phone:253-472-2225
Practice Address - Fax:253-474-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty