Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2833 | WA |
N | 111NS0005X | Chiropractic Sports Physician | 2833 | WA |
NPI | 1134119340 |
---|---|
Provider Name | Dr. John Michael Lewis JR. |
First Address | Seattle, WA 98102-7125 |
Second Address | Seattle, WA 98102-7125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46684 | LABOR & INDUSTRIES (01) | WA |
8933964 | CRIME VICTIMS (01) | WA |
U41848 | (02) |