Back, Michael B
Back, Michael B is an sole proprietor health care provider with primary practice located at 11802 Ne 65Th St Suite 100, Vancouver WA 98662-5521. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Back, Michael B can be contacted via phone (360) 253-6883.Contact Information
Primary practice address
11802 Ne 65Th St Suite 100
Vancouver WA 98662-5521
Phone: (360) 253-6883
Fax: (360) 892-7040
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CH00002774 | Washington |
Profile Details
| NPI number | 1962407080 |
|---|---|
| LBN Legal business name | Back, Michael B |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Feb 19th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962407080 | NPPES |
| Washington | MEDICAID | 84058466 | |
| Washington | Other | 0187146 | |
| Washington | Other | P00169111 |
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