Active NPI
Vanessa R Wise, D.C.
- Chiropractor
- Lake Stevens, WA
National Provider Identifier
1053684241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH60269388
- Practice address
- 905 Sr 9
Lake Stevens, WA 98258-9484 - Phone
- (425) 334-5066
- Fax
- (425) 335-4787
- NPI assigned
- Feb 17, 2012
- 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 | CH60269388 | WA | Primary |
Addresses
Primary practice location
905 Sr 9
Lake Stevens, WA 98258-9484
Mailing address
905 Sr 9
Lake Stevens, WA 98258-9484
Phone (425) 334-5066
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH60269388 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation Chiropractic P.S. | Chiropractor | Current | Accepting new patients |
| Momentum Clinic | Chiropractor | Current | Accepting new patients |
Locations
905 State Route 9 NE
Lake Stevens, WA 98258
Phone (425) 334-5066
Organizations & group practices 2
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": "1329436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329436800000",
"number": "1053684241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SR 9",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982589484",
"telephone_number": "425-334-5066",
"fax_number": "425-335-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 SR 9",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982589484",
"telephone_number": "425-334-5066",
"fax_number": "425-335-4787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "VANESSA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-17",
"last_updated": "2012-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH60269388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.