Provider Demographics
NPI:1619083094
Name:BEDLINGTON, RAYMOND ALDEN (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ALDEN
Last Name:BEDLINGTON
Suffix:
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:PO BOX 160
Mailing Address - Street 2:BEDLINGTON CHIROPRACTIC CENTER PS
Mailing Address - City:EVERSON
Mailing Address - State:WA
Mailing Address - Zip Code:98247-0160
Mailing Address - Country:US
Mailing Address - Phone:360-966-5844
Mailing Address - Fax:360-966-7718
Practice Address - Street 1:211 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-0160
Practice Address - Country:US
Practice Address - Phone:360-966-5844
Practice Address - Fax:360-966-7718
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0002655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2016178Medicaid
U29872Medicare UPIN
WA2016178Medicaid