Individual provider Active NPI

Wade Dean Burbank, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1093753667
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033654 Issued in WA
Practice address
6403 NE 117TH Ave
Suite 109
Vancouver, WA 98662-5560
Phone
(360) 567-1739
Fax
(360) 256-0300
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033654 WA Primary

Addresses

Primary practice location

6403 NE 117TH Ave
Suite 109
Vancouver, WA 98662-5560

Mailing address

6403 NE 117TH Ave
Suite 109
Vancouver, WA 98662-5560
Phone (360) 567-1739

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

LicenseStateTypeSpecialty
CH00033654WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crofts Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1093753667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6403 NE 117TH AVE",
            "address_2": "SUITE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625560",
            "telephone_number": "360-567-1739",
            "fax_number": "360-256-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6403 NE 117TH AVE",
            "address_2": "SUITE 109",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986625560",
            "telephone_number": "360-567-1739",
            "fax_number": "360-256-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBANK",
        "first_name": "WADE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033654",
            "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 Jun 30, 2010; 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.