Organization Active NPI

Health and Wellness Clinic PLLC

  • Health Service Clinic/Center
  • Edmonds, WA
National Provider Identifier
1033388772
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
CH00034858 Issued in WA
Legal business name
HEALTH AND WELLNESS CLINIC PLLC
Practice address
22005 76TH Ave W
Edmonds, WA 98026-7905
Phone
(425) 776-3800
Fax
(425) 776-3844
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Dr. Jennifer Lee Ricker, D.C.NPI 1457538621
Title
Chiropractor/Owner
Phone
(425) 776-3800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X CH00034858 WA Primary

Addresses

Primary practice location

22005 76TH Ave W
Edmonds, WA 98026-7905

Mailing address

22005 76TH Ave W
Edmonds, WA 98026-7905
Phone (425) 776-3800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000041 WA Part B Supplier - Clinic/Group Practice 2668520909 Receives reassigned benefits from 1 practitioner
Practice locations: Edmonds, WA

National Provider Directory

National Provider Directory

Locations

22005 76th Ave W
Edmonds, WA 98026
Phone (425) 670-9097

Practitioners & affiliated clinicians

Practitioners 6

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": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1033388772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22005 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267905",
            "telephone_number": "425-776-3800",
            "fax_number": "425-776-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22005 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267905",
            "telephone_number": "425-776-3800",
            "fax_number": "425-776-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND WELLNESS CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "425-776-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "CH00034858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.