Provider Demographics
NPI:1548979586
Name:DAUTOVIC, ALDIN (DC)
Entity type:Individual
Prefix:DR
First Name:ALDIN
Middle Name:
Last Name:DAUTOVIC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ALDIN
Other - Middle Name:
Other - Last Name:DAUTOVIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:12340 NE 115TH PL APT 233
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4483
Mailing Address - Country:US
Mailing Address - Phone:319-504-7790
Mailing Address - Fax:
Practice Address - Street 1:511 BOREN AVE N STE 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5505
Practice Address - Country:US
Practice Address - Phone:206-324-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61376657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1992830277OtherOTHER PROVIDER NPI