Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH 60011808 | WA |
Y | 111NP0017X | Pediatric Chiropractor | CH60011808 | WA |
NPI | 1477718344 |
---|---|
Provider Name | Dr. Trevin James Ziegler |
First Address | Olympia, WA 98507 |
Second Address | Olympia, WA 98502-5467 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2008 |
Last Update Date | 01/06/2016 |