Fairbanks, Vaughn Roger

Fairbanks, Vaughn Roger is an individual health care provider with primary practice located at 414 South Beech Street , Moses Lake WA 98837. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fairbanks, Vaughn Roger can be contacted via phone (509) 765-9235.

Contact Information

Primary practice address
414 South Beech Street Moses Lake WA 98837
Fax: (509) 765-9235
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CH00003350 Washington

Profile Details

NPI number 1659593614
LBN Legal business name Fairbanks, Vaughn Roger
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2007
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659593614 NPPES
Washington Other 111104 STATE DLI
Washington Other FAIVA0200461618 STATE DLI

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