Provider Demographics
NPI:1679891410
Name:PLANCICH, REANNA LEE (DC)
Entity type:Individual
Prefix:DR
First Name:REANNA
Middle Name:LEE
Last Name:PLANCICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24025 FLORAL WAY
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8439
Mailing Address - Country:US
Mailing Address - Phone:206-669-6459
Mailing Address - Fax:
Practice Address - Street 1:6739 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5508
Practice Address - Country:US
Practice Address - Phone:206-669-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60157667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor