| Advanced Chiropractic Centre Corp | |
|
705 Se Park Crest Ave., Ste A120, Vancouver, WA 98683-1303 | |
| (360) 892-3654 | |
| (360) 892-3692 |
| Full Name | Advanced Chiropractic Centre Corp |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 705 Se Park Crest Ave., Ste A120, Vancouver, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710032057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NS0005X | Chiropractor - Sports Physician | CH00003418 (Washington) | Primary |
| Provider Name | Larry L Wasilenkoff |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659442135 PECOS PAC ID: 9537153044 Enrollment ID: I20120127000531 |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Chiropractic Centre Corp 705 Se Park Crest Ave., Ste A120, Vancouver, WA 98683-1303 Ph: (360) 892-3654 | Advanced Chiropractic Centre Corp 705 Se Park Crest Ave., Ste A120, Vancouver, WA 98683-1303 Ph: (360) 892-3654 |
Nicole Marie Granger, LMT, LMP Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 13712 Ne 20th Ave, Vancouver, WA 98686 Phone: 360-574-5944 | |
Mrs. Oksana I Bondarenko, Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 13518 Ne 1st Pl, Vancouver, WA 98685 Phone: 360-607-4894 | |
Dr. David Isaac Johnson, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 11500 Ne 119th St Ste 104, Vancouver, WA 98662 Phone: 360-326-3396 Fax: 360-369-0015 | |
Dr. Brandon James Mccuistion, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1307 Ne 78th Street, Suite C, Vancouver, WA 98665 Phone: 360-573-1933 | |
Andrew Marino, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 2415 Se 165th Ave Ste 105, Vancouver, WA 98683 Phone: 360-823-2225 Fax: 360-823-2227 | |
Mobile Chiropractic North West , Inc. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 9403 Ne 116th Ave, Vancouver, WA 98662 Phone: 360-909-1800 | |
Kim D Christensen, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 12503 Se Mill Plain Blvd, Suite 215a, Vancouver, WA 98684 Phone: 360-448-6353 Fax: 240-371-7188 |