EAGLE HARBOR HEALTH & CHIROPRACTIC (NPI# 1881964419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881964419 |
| Entity Type | Organization |
| Organization Name | EAGLE HARBOR HEALTH & CHIROPRACTIC |
| Practice Address |
931 Hildebrand Ln Ne # 101a Bainbridge Island WA 98110-2823 |
| Mailing Address |
931 Hildebrand Ln Ne # 101 Bainbridge Island WA 98110-2823 |
| Practice Telephone | 1206842269 |
| Practice Fax Number | 2068422847 |
| Mailing Telephone | 2068422690 |
| Mailing Fax Number | 2068422847 |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | DR. KIRK WILLIAM PETHERAM (OWNER) |
| Authorized Official Telephone | 2068422702 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH00003554 | WA | Chiropractic Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EAGLE HARBOR HEALTH & CHIROPRACTIC CENTER, LLC | 931 Hilderbrand Ln, Suite 101, Bainbridge Island, WA 98110-2823 |
| Street Address |
931 HILDEBRAND LN NE # 101A |
| City | BAINBRIDGE ISLAND |
| State | WA |
| Zip Code | 98110-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427667021 | William Reddy | Counselor | 8380 Ne Beck Road, Bainbridge Island, WA 98110 | 2020-07-29 |
| 1144875352 | Kaitlyn Barr | Physical Therapist | Kitsap Physical Therapy, 945 Hildebrand Ln Ste 220, Bainbridge Island, WA 98110 | 2019-08-05 |
| 1326601055 | Chloe Samantha Simon | Specialist/Technologist | 9650 Green Spot Pl., Req, Bainbridge Island, WA 98110 | 2019-04-18 |
| 1043721228 | Laura West Baker | Counselor | 11073 Madison Ave. N.e., Bainbridge Island, WA 98110 | 2017-10-16 |
| 1609305978 | Autism Coaching, Consulting, and Training, LLC | Early Intervention Provider Agency | 676 Lovell Ave Nw, Bainbridge Island, WA 98110 | 2017-06-08 |
| 1639423692 | Alice Hunting | Massage Therapist | 11700 Ne Meadowmeer Circle, Bainbridge Island, WA 98110 | 2012-10-30 |
| 1578813929 | Kitsap County Fire District No 2 | Ambulance | 8895 Madison Ave Ne, Bainbridge Island, WA 98110 | 2012-09-13 |
| 1841582707 | David Warren Sugarman | Psychologist | 4080 Crystal Springs Dr Ne, Bainbridge Island, WA 98110 | 2011-05-11 |
| 1346570371 | Trina Ann Peterson | Registered Nurse | 2213 N.e. Victorian Lane, C, Bainbridge Island, WA 98110 | 2010-01-14 |
| 1902135437 | Sally Karen Vest | Occupational Therapy Assistant | 10861 Manitou Park Blvd. Ne, Bainbridge Island, WA 98110 | 2009-12-11 |
| Find all providers in zip 98110 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205291564 | Justin Paquette, Dc | Chiropractor | 190 Harbor Sq Loop Ne Unit C328, Bainbridge Island, WA 98110-2488 | 2015-12-30 |
| 1831566389 | Morgan Lee Rilling | Chiropractor | 650 Ericksen Ave Ne Apt 3, Bainbridge Island, WA 98110-2821 | 2015-08-31 |
| 1558631796 | Island Health and Chiropractic, LLC | Chiropractor | 9431 Coppertop Loop Ne Ste 204, Bainbridge Island, WA 98110-3684 | 2012-01-05 |
| 1497065247 | Healing Waters,llc | Chiropractor | 164 Knechtel Ave. Nw, Bainbridge Island, WA 98110-3537 | 2010-10-14 |
| 1205039096 | Richard Stocker | Chiropractor | 385 Ericksen Ave Ne, Suite 112, Bainbridge Island, WA 98110-1886 | 2007-06-07 |
| 1396952040 | Mari Linda Ellingsen | Chiropractor | 2 On The Square, Bainbridge Island, WA 98110 | 2007-05-16 |
| 1396957403 | Malik B.j. Singh Prihar | Chiropractor | 1050 Hildebrand Ln Ne, Ste-102, Bainbridge Island, WA 98110-2863 | 2007-05-03 |
| 1477684231 | Eagle Harbor Chiropractic Inc.p.s. | Chiropractor | 748 Winslow Way E, Bainbridge Island, WA 98110-2410 | 2007-03-07 |
| 1770613580 | Kirk W Petheram | Chiropractor | 701 Winslow Way E Ste B, Bainbridge Island, WA 98110-2416 | 2007-03-07 |
| 1942330741 | Lucia Vracin | Chiropractor | 9431 Coppertop Loop Ne Unit 204, Bainbridge Island, WA 98110-3684 | 2007-03-07 |
| Find all providers in BAINBRIDGE ISLAND | ||||
| City | BAINBRIDGE ISLAND |
| Zip Code | 98110 |
Please comment or provide details below to improve the information on EAGLE HARBOR HEALTH & CHIROPRACTIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.