NPIMap

Organization Active NPI

Camacho Chiropractic and Sports Medicine LLC

  • Rehabilitation Clinic/Center
  • Grandview, WA
National Provider Identifier
1013488360
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
CAMACHO CHIROPRACTIC AND SPORTS MEDICINE LLC
Practice address
403 N Euclid St
Grandview, WA 98930-9407
Phone
(509) 402-9020
Fax
(509) 402-9036
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela Marie Camacho
Title
Office Manager
Phone
(509) 402-9020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Independent Medical Examiner ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NI0013X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

403 N Euclid St
Grandview, WA 98930-9407

Mailing address

403 N Euclid St
Grandview, WA 98930-9407
Phone (509) 402-9020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190212001905 WA Part B Supplier - Clinic/Group Practice 1355689654 Receives reassigned benefits from 2 practitioners
Practice locations: Grandview, WA

National Provider Directory

National Provider Directory

Locations

105 E 2nd St
Grandview, WA 98930
Phone (509) 402-9020

403 N Euclid St
Grandview, WA 98930
Phone (509) 402-9020

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1013488360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N EUCLID ST",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989309407",
            "telephone_number": "509-402-9020",
            "fax_number": "509-402-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N EUCLID ST",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989309407",
            "telephone_number": "509-402-9020",
            "fax_number": "509-402-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMACHO CHIROPRACTIC AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-402-9020"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.