Individual provider Active NPI

Raymon Kooner, DC

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1053404038
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHOOO34656 Issued in WA
Practice address
10655 NE 4TH St
101
Bellevue, WA 98004-5035
Phone
(503) 860-8859
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHOOO34656 WA Primary

Addresses

Primary practice location

10655 NE 4TH St
101
Bellevue, WA 98004-5035

Mailing address

10655 NE 4TH St
101
Bellevue, WA 98004-5035
Phone (503) 860-8859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070208000587 WA Practitioner - Chiropractic 1254330871 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHOOO34656WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
C1 Renton PLLC Chiropractor CurrentSince Sep 1, 2025 Accepting new patients
Olympic View Chiropractic, PS Chiropractor CurrentSince Jul 1, 2020 Accepting new patients
Tacoma Wellness Center, PLLC Chiropractor PastSince Sep 25, 2014 Accepting new patients
Backfire Inc P S Chiropractor PastSince Feb 19, 2024 Accepting new patients
On-Site Massage, Inc. Past Accepting new patients
Ty C Westenhaver Chiropractor PastSince Apr 1, 1998 Accepting new patients
Natural Wellness Center, PS Chiropractor PastSince Aug 1, 2025 Accepting new patients
Avise Chiropractic P L L C Chiropractor PastSince Sep 15, 2023 Accepting new patients

Locations

626 128th St SW
Ste 103B
Everett, WA 98204
Phone (425) 513-1880

3459 S 152nd St
Tukwila, WA 98188
Phone (206) 241-2225

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1053404038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "503-860-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "503-860-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONER",
        "first_name": "RAYMON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CHOOO34656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.