Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH00001364 | WA |
NPI | 1720071020 |
---|---|
Provider Name | Dr. Laurin Jay Mcelheran |
First Address | Bellevue, WA 98007-3908 |
Second Address | Bellevue, WA 98007-3908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T01722 | (02) | WA |