Provider Demographics
NPI:1679980171
Name:LIEBING, ALLEN (DC, MS)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:LIEBING
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 W GAGE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7162
Mailing Address - Country:US
Mailing Address - Phone:509-737-1400
Mailing Address - Fax:509-737-1406
Practice Address - Street 1:8530 W GAGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7162
Practice Address - Country:US
Practice Address - Phone:509-737-1400
Practice Address - Fax:509-737-1406
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60610717111N00000X
OR5574111N00000X
WA60610717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor