Provider Demographics
NPI:1942330741
Name:FLETCHER, LUCIA VRACIN (DC)
Entity type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:VRACIN
Last Name:FLETCHER
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 1:625 N 5TH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-5062
Mailing Address - Country:US
Mailing Address - Phone:206-605-0179
Mailing Address - Fax:
Practice Address - Street 1:625 N 5TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-5062
Practice Address - Country:US
Practice Address - Phone:206-605-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22670111N00000X
WA3595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB34482Medicare ID - Type Unspecified