Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH00034479 | WA |
N | 111N00000X | Chiropractor | CHOOO34479 | WA |
Y | 111NN0400X | Neurology | CH00034479 | WA |
N | 111NN0400X | Neurology | CH0034479 | WA |
N | 111NN1001X | Nutrition | CH00034479 | WA |
NPI | 1700903259 |
---|---|
Provider Name | Dr. Jason Penaluna |
First Address | Shoreline, WA 98133-6547 |
Second Address | Shoreline, WA 98133-6547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 28/10/2020 |