Organization · NPI-2

Active Life Chiropractic Clinic LLC

Chiropractor, Sports Physician · Yakima, WA

NPI number1174877955
StatusActive
Last updated in NPPESMar 31, 2026

Details

NPI
1174877955
Entity type
Organization (NPI-2)
Legal business name
Active Life Chiropractic Clinic LLC
Organization subpart
No
Enumeration date
Nov 1, 2012
Certification date
Mar 31, 2026
Last updated
Mar 31, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NS0005X Chiropractor, Sports PhysicianCH60309681WAYes
111NP0017X Chiropractor, Pediatric ChiropractorCH60309681WA
225700000X Massage Therapist––
111NS0005X Chiropractor, Sports PhysicianCH60309678WA

Other names

  • Active Life Chiropractic (Doing Business As)

Practice location

1015 S 40th Ave Ste 21
Yakima, WA 98908-3868

Phone 509-965-9820 · Fax 509-965-9822

Mailing address

1015 S 40th Ave Ste 21
Yakima, WA 98908-3868

Phone 509-965-9820 · Fax 509-965-9822

Authorized official

Kristina Lynn Coppock
Owner/Doctor/Office Manager
5099659820

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