Organization Active NPI

Balanced Living Chiropractic PLLC

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1104308311
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60153876 Issued in WA
Legal business name
BALANCED LIVING CHIROPRACTIC PLLC
Practice address
6405 NE 116TH Ave Ste 106
Vancouver, WA 98662-2402
Phone
(360) 597-4784
NPI assigned
Sep 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Joseph Perin, DCNPI 1659672012
Title
Owner
Phone
(360) 597-4784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH60153876 WA Primary

Addresses

Primary practice location

6405 NE 116TH Ave Ste 106
Vancouver, WA 98662-2402

Mailing address

6405 NE 116TH Ave Ste 106
Vancouver, WA 98662-2402
Phone (360) 597-4784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200706000859 WA Part B Supplier - Clinic/Group Practice 0244653566 Receives reassigned benefits from 2 practitioners
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

6405 NE 116th Ave
Ste 106
Vancouver, WA 98662
Phone (360) 597-4784

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": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1104308311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 NE 116TH AVE STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986622402",
            "telephone_number": "360-597-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 NE 116TH AVE STE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986622402",
            "telephone_number": "360-597-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "PERIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-597-4784",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60153876",
            "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 Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.