Provider Demographics
NPI:1700903259
Name:PENALUNA, JASON (DC DACNB FABNN)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:PENALUNA
Suffix:
Gender:M
Credentials:DC DACNB FABNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14709 AURORA AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6547
Mailing Address - Country:US
Mailing Address - Phone:206-363-4478
Mailing Address - Fax:206-363-4640
Practice Address - Street 1:14709 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6547
Practice Address - Country:US
Practice Address - Phone:206-363-4478
Practice Address - Fax:206-363-4640
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACHOOO34479111N00000X
WACH00034479111N00000X, 111NN1001X, 111NN0400X
WACH0034479111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition