Provider Demographics
NPI:1023467701
Name:BATTLE GROUND CHIROPRACTIC, PS
Entity type:Organization
Organization Name:BATTLE GROUND CHIROPRACTIC, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:STRAPPAZON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-687-3181
Mailing Address - Street 1:1908 NW 1ST WAY STE 113
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4560
Mailing Address - Country:US
Mailing Address - Phone:360-687-3181
Mailing Address - Fax:360-687-1992
Practice Address - Street 1:1908 NW 1ST WAY STE 113
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4560
Practice Address - Country:US
Practice Address - Phone:360-687-3181
Practice Address - Fax:360-687-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2120161Medicaid
WA362139OtherDEPART OF L&I