NPIMap

Organization Active NPI

Dr. Jerry Wang, D.C., P.S., Inc.

Doing business as Eastside Family Chiropractic

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1053435214
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3517 Issued in WA
Legal business name
DR. JERRY WANG, D.C., P.S., INC.
Doing business as
Eastside Family Chiropractic
Practice address
1750 112TH Ave NE Ste C240
Bellevue, WA 98004-5233
Phone
(425) 688-1994
Fax
(425) 688-1990
NPI assigned
Mar 16, 2007
Last updated
May 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Dr. Jerry Wang, D.C.NPI 1740320795
Title
President
Phone
(425) 688-1994

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
Chiropractor 111N00000X 3517 WA Primary

Addresses

Primary practice location

1750 112TH Ave NE Ste C240
Bellevue, WA 98004-5233

Mailing address

1750 112TH Ave NE Ste C240
Bellevue, WA 98004-5233
Phone (425) 688-1994

Other names 1

  • Eastside Family Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

1750 112th Ave NE
Ste C240
Bellevue, WA 98004
Phone (425) 688-1994

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1053435214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE STE C240",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045233",
            "telephone_number": "425-688-1994",
            "fax_number": "425-688-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 112TH AVE NE STE C240",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045233",
            "telephone_number": "425-688-1994",
            "fax_number": "425-688-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERRY WANG, D.C., P.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-688-1994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.