Provider Demographics
NPI:1669540654
Name:DRURY, TERRI J (DC)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:J
Last Name:DRURY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-3317
Mailing Address - Country:US
Mailing Address - Phone:509-758-0660
Mailing Address - Fax:509-751-9214
Practice Address - Street 1:1303 6TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-3317
Practice Address - Country:US
Practice Address - Phone:509-758-0660
Practice Address - Fax:509-751-9214
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2016624Medicaid
WAU32364Medicare UPIN
WA2016624Medicaid