Basic Information
| Provider Information | |||||||||
| NPI: | 1033393590 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOREY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LMP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4701 AUBURN WAY N | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980021312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538502225 | ||||||||
| FaxNumber: | 2538505757 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 AUBURN WAY N | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980021312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538502225 | ||||||||
| FaxNumber: | 2538505757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2007 | ||||||||
| LastUpdateDate: | 12/19/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | MA00022674 | WA | Y | Chiropractic Providers | Chiropractor |
No ID Information.