Provider Demographics
NPI:1053625863
Name:KELVIN WASHINGTON, DC., P.C.
Entity type:Organization
Organization Name:KELVIN WASHINGTON, DC., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-838-2443
Mailing Address - Street 1:25797 CONIFER RD
Mailing Address - Street 2:SUITE B211
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9053
Mailing Address - Country:US
Mailing Address - Phone:303-838-2443
Mailing Address - Fax:
Practice Address - Street 1:25797 CONIFER RD
Practice Address - Street 2:SUITE C210
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9053
Practice Address - Country:US
Practice Address - Phone:303-838-2443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3605111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty