NPIMap

Organization Active NPI

Tukwila Community Chiropractic PLLC

  • Chiropractor
  • Tukwila, WA
National Provider Identifier
1033414552
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003356 Issued in WA
Legal business name
TUKWILA COMMUNITY CHIROPRACTIC PLLC
Practice address
7100 Fun Center Way
#120
Tukwila, WA 98188
Phone
(425) 251-3101
Fax
(206) 582-2976
NPI assigned
Jan 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Authorized official

Name
Dr. Mark Thomas Huck, DR. CHIROPRACTOR
Title
Chiropractor
Phone
(425) 251-3101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00003356 WA Primary
Clinic/Center 261Q00000X CH00003356 WA

Addresses

Primary practice location

7100 Fun Center Way
#120
Tukwila, WA 98188

Mailing address

7100 Fun Center Way
#120
Tukwila, WA 98188
Phone (425) 251-3101

Other identifiers 2

IdentifierTypeStateIssuer
132063OtherWALABOR AND INDUSTRIES
HU5492OtherWABLUE CROSS

Other names 1

  • Dr. Mark Huck Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110118001078 WA Part B Supplier - Clinic/Group Practice 5193914455 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tukwila, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1033414552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 FUN CENTER WAY",
            "address_2": "#120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "425-251-3101",
            "fax_number": "206-582-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 FUN CENTER WAY",
            "address_2": "#120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "425-251-3101",
            "fax_number": "206-582-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUKWILA COMMUNITY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "HUCK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "425-251-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR. CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003356",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "CH00003356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "132063",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HU5492",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Mark Huck",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.