Provider Demographics
NPI:1659672012
Name:PERIN, JOSEPH FRED SR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRED
Last Name:PERIN
Suffix:SR
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 1:6405 NE 116TH AVE.
Mailing Address - Street 2:SUITE #106
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662
Mailing Address - Country:US
Mailing Address - Phone:360-597-4784
Mailing Address - Fax:360-597-4214
Practice Address - Street 1:6405 NE 116TH AVE.
Practice Address - Street 2:SUITE #106
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662
Practice Address - Country:US
Practice Address - Phone:360-597-4784
Practice Address - Fax:360-597-4214
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA621310111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography