Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00034279 | WA |
N | 111NI0013X | Independent Medical Examiner | CH00034279 | WA |
NPI | 1124062849 |
---|---|
Provider Name | Dr. Xavier Inac Ibarreta |
First Address | Des Moines, WA 98198-7281 |
Second Address | Des Moines, WA 98198-7281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 10/10/2017 |