Provider Demographics
NPI:1770786493
Name:ADVANCED SPINAL CARE, INC
Entity type:Organization
Organization Name:ADVANCED SPINAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAPENSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-879-5673
Mailing Address - Street 1:21806 103RD AVENUE CT E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-8115
Mailing Address - Country:US
Mailing Address - Phone:253-445-8181
Mailing Address - Fax:253-445-7938
Practice Address - Street 1:21806 103RD AVENUE CT E
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8115
Practice Address - Country:US
Practice Address - Phone:253-445-8181
Practice Address - Fax:253-445-7938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0160371OtherLABOR AND INDUSTRIES
WAAB28384Medicare ID - Type UnspecifiedPRACTICE ID #