Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH60022455 | WA |
NPI | 1003038977 |
---|---|
Provider Name | Michael J Covington |
First Address | Yakima, WA 98908-3048 |
Second Address | Yakima, WA 98908-3048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 25/04/2016 |