OrganizationActive
Advanced Chiropractic Centre Corp
NPI 1710032057 · Sports Physician Chiropractor · Vancouver, WA
Provider details
- NPI number
- 1710032057
- Entity type
- Organization
- Primary specialty
- Sports Physician ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Larry Wasilenkoff, Owner(360) 892-3654
- License
- CH00003418 (WA)
Specialties & taxonomies
Chiropractic Providers
Practice location
705 Se Park Crest Ave., Ste A120
Vancouver, WA 98683-1303
Phone: (360) 892-3654
Fax: (360) 892-3692
Approximate (ZIP-level) locationGet directions
Mailing address
705 Se Park Crest Ave., Ste A120
Vancouver, WA 98683-1303
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.