Provider Demographics
NPI:1548318975
Name:PENRY, DAREN J (DC)
Entity type:Individual
Prefix:
First Name:DAREN
Middle Name:J
Last Name:PENRY
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 1:10518 NE 68TH ST
Mailing Address - Street 2:B101
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7003
Mailing Address - Country:US
Mailing Address - Phone:425-889-4701
Mailing Address - Fax:425-889-4702
Practice Address - Street 1:10518 NE 68TH ST
Practice Address - Street 2:B101
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7003
Practice Address - Country:US
Practice Address - Phone:425-889-4701
Practice Address - Fax:425-889-4702
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor