Organization Active NPI

New Life Chiropractic Inc PS

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1083753396
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034176 Issued in WA
Legal business name
NEW LIFE CHIROPRACTIC INC PS
Practice address
19503 56TH Ave W
Ste a
Lynnwood, WA 98036-5225
Phone
(425) 776-8303
Fax
(425) 776-8363
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brice P Kovarik, DC
Title
President
Phone
(425) 776-8303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034176 WA Primary

Addresses

Primary practice location

19503 56TH Ave W
Ste a
Lynnwood, WA 98036-5225

Mailing address

19503 56TH Ave W
Ste a
Lynnwood, WA 98036-5225
Phone (425) 776-8303

Other names 1

  • New Life Chiropractic Former legal business name

National Provider Directory

National Provider Directory

Locations

19503 56th Ave W
Ste A
Lynnwood, WA 98036
Phone (425) 776-8030

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083753396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19503 56TH AVE W",
            "address_2": "STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365225",
            "telephone_number": "425-776-8303",
            "fax_number": "425-776-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19503 56TH AVE W",
            "address_2": "STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365225",
            "telephone_number": "425-776-8303",
            "fax_number": "425-776-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE CHIROPRACTIC INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOVARIK",
        "authorized_official_first_name": "BRICE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-776-8303",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.