Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH 60161920 | WA |
Y | 111NR0400X | Rehabilitation Chiropractor | CH 60161920 | WA |
N | 111NS0005X | Chiropractic Sports Physician | CH 60161920 | WA |
NPI | 1114231172 |
---|---|
Provider Name | Dr. Trevor Donald Gilbert |
First Address | Bellevue, WA 98005-2972 |
Second Address | Bellevue, WA 98005-2972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 21/02/2011 |