| Stability Spine & Wellness | |
|
1225 Dexter Ave N, Seattle, WA 98109-3518 | |
| (206) 497-4962 | |
| (206) 316-8655 |
| Full Name | Stability Spine & Wellness |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1225 Dexter Ave N, Seattle, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386920171 | NPI | - | NPPES |
| 0261812 | Other | WA | LABOR AND INDUSTRIES - INDIVIDUAL |
| 1023194339 | Other | INDIVIDUAL NPI | |
| 8870884 | Other | WA | MEDICARE PTAN |
| 0268936 | Other | WA | LABOR AND INDUSTRIES - GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH00034786 (Washington) | Primary |
| Provider Name | Justin J Favreau |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023194339 PECOS PAC ID: 1456450436 Enrollment ID: I20071213000586 |
| Mailing Address | Practice Location Address |
|---|---|
| Stability Spine & Wellness 1225 Dexter Ave N, Seattle, WA 98109-3518 Ph: (206) 497-4962 | Stability Spine & Wellness 1225 Dexter Ave N, Seattle, WA 98109-3518 Ph: (206) 497-4962 |
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