Active NPI
Havalah Noel Carlson, DC
- Chiropractor
- Ridgefield, WA
National Provider Identifier
1033816103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH61380047
- Practice address
- 414 Pioneer St Ste 102
Ridgefield, WA 98642-4512 - Phone
- (360) 887-2135
- NPI assigned
- Feb 9, 2023
- Last updated
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH61380047 | WA | Primary |
Addresses
Primary practice location
414 Pioneer St Ste 102
Ridgefield, WA 98642-4512
Mailing address
13203 NE 60TH Ave
Vancouver, WA 98686-4949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH61380047 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridgefield Chiropractic LLC | Chiropractor | Current | Accepting new patients |
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1033816103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13203 NE 60TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986864949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 PIONEER ST STE 102",
"city": "RIDGEFIELD",
"state": "WA",
"postal_code": "986424512",
"telephone_number": "360-887-2135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "HAVALAH",
"middle_name": "NOEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH61380047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgefield, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.