Provider Demographics
NPI:1174698583
Name:BAINS, RANJIV SINGH (DC)
Entity type:Individual
Prefix:MR
First Name:RANJIV
Middle Name:SINGH
Last Name:BAINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15324 MAIN ST E STE B
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-2698
Mailing Address - Country:US
Mailing Address - Phone:253-863-5323
Mailing Address - Fax:253-863-2034
Practice Address - Street 1:15324 MAIN ST E STE B
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-2698
Practice Address - Country:US
Practice Address - Phone:253-863-5323
Practice Address - Fax:253-863-2034
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0166311OtherLNI
WA3419BAOtherREGENCE B/S
WA91-1580839OtherGROUP ID TAX NUMBER
WACH00034177OtherLICENSE NUMBER
WA0119433OtherLNI GROUP
WA91-1580839OtherGROUP ID TAX NUMBER
WACH00034177OtherLICENSE NUMBER