Individual provider Active NPI

Brooke Kristen Danielson, LMP

  • Specialist
  • Vancouver, WA
National Provider Identifier
1083818447
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA0024065 Issued in WA
Practice address
Grafton Family Chiropractic 615 SE Chkalov Dr.
Suite 7
Vancouver, WA 98683
Phone
(360) 885-1767
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA0024065 WA Primary

Addresses

Primary practice location

Grafton Family Chiropractic 615 SE Chkalov Dr.
Suite 7
Vancouver, WA 98683

Mailing address

1417 NW 30TH Ave
Camas, WA 98607-9387
Phone (360) 834-2945

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA0024065WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083818447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 NW 30TH AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079387",
            "telephone_number": "360-834-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRAFTON FAMILY CHIROPRACTIC 615 SE CHKALOV DR.",
            "address_2": "SUITE 7",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98683",
            "telephone_number": "360-885-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "BROOKE",
        "middle_name": "KRISTEN",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA0024065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.