Individual provider Active NPI

Ariene Chang, D.C.

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1124110614
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034133 Issued in WA
Practice address
4320 196TH St SW Ste A1
Lynnwood, WA 98036-6773
Phone
(425) 224-5589
NPI assigned
Sep 29, 2006
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034133 WA Primary

Addresses

Primary practice location

4320 196TH St SW Ste A1
Lynnwood, WA 98036-6773

Mailing address

PO Box 2694
Lynnwood, WA 98036-2694
Phone (425) 224-5589

Other identifiers 2

IdentifierTypeStateIssuer
0171393OtherWALABOR & INDUSTRIES
217421250709OtherWAPREMERA

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
CH00034133WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Wellness Center,PLLC Chiropractor PastSince Feb 1, 2007 Accepting new patients
Premier Chiropractic #7, PLLC Chiropractor PastSince Jun 10, 2004 Accepting new patients
South Tacoma Chiropractic and Rehabilitation, PLLC Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1124110614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2694",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980362694",
            "telephone_number": "425-224-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 196TH ST SW STE A1",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366773",
            "telephone_number": "425-224-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ARIENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0171393",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "217421250709",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 2, 2022; 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.