Active NPI
Gary Lee Rutledge, D.C.
- Chiropractor
- Duvall, WA
National Provider Identifier
1154320653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 025202CH00001323
- Practice address
- 15435 Main NE
Duvall, WA 98019-0820 - Phone
- (425) 788-4625
- Fax
- (425) 844-2557
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 025202CH00001323 | WA | Primary |
Addresses
Primary practice location
15435 Main NE
Duvall, WA 98019-0820
Mailing address
15435 Main NE
Post Office Box 820
Duvall, WA 98019-0820
Phone (425) 788-4625
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025202CH00001323 | Other | WA | STATE LICENSE |
| 6011700132 | Other | WA | UBI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025202CH00001323 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1154320653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15435 MAIN NE",
"address_2": "POST OFFICE BOX 820",
"city": "DUVALL",
"state": "WA",
"postal_code": "980190820",
"telephone_number": "425-788-4625",
"fax_number": "425-844-2557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15435 MAIN NE",
"city": "DUVALL",
"state": "WA",
"postal_code": "980190820",
"telephone_number": "425-788-4625",
"fax_number": "425-844-2557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "025202CH00001323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "025202CH00001323",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBI",
"identifier": "6011700132",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duvall, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.