Active NPI
Colin M Derieg, DC
- Chiropractor
- Everett, WA
National Provider Identifier
1063454890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 33834
- Practice address
- 5301 Evergreen Way
Everett, WA 98203-3631 - Phone
- (425) 257-1000
- Fax
- (425) 353-6787
- NPI assigned
- Jun 13, 2006
- Last updated
- Oct 17, 2018
- Sex
- Male
- 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 | 33834 | WA | Primary |
Addresses
Primary practice location
5301 Evergreen Way
Everett, WA 98203-3631
Mailing address
14524 Main St NE Ste 119
Duvall, WA 98019-8467
Phone (425) 844-8000
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 |
|---|---|---|---|
| 33834 | WA | MD | Chiropractor |
| 025202 | WA | MD | Rehabilitation Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hansen Chiropractic PS | Chiropractor | Past | Accepting new patients |
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": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1063454890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14524 MAIN ST NE STE 119",
"city": "DUVALL",
"state": "WA",
"postal_code": "980198467",
"telephone_number": "425-844-8000",
"fax_number": "425-788-8445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 EVERGREEN WAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982033631",
"telephone_number": "425-257-1000",
"fax_number": "425-353-6787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERIEG",
"first_name": "COLIN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "33834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.