Provider Demographics
NPI:1548301369
Name:GUTIERREZ, ANTHONY III (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:GUTIERREZ
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 172ND ST NE
Mailing Address - Street 2:STE N
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6336
Mailing Address - Country:US
Mailing Address - Phone:360-688-3818
Mailing Address - Fax:360-651-2344
Practice Address - Street 1:3704 172ND ST NE
Practice Address - Street 2:SUITE N
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6336
Practice Address - Country:US
Practice Address - Phone:360-658-3818
Practice Address - Fax:360-651-2344
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3195111N00000X
SC2236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1685GUOtherREGENCE
WA104848OtherL & I
WA911868835OtherCORPOATE TAX ID
WA104848OtherL & I
WA1685GUOtherREGENCE