Wakeland Chiropractic Center Inc PS

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00002197 Issued in WA

Legal business name

WAKELAND CHIROPRACTIC CENTER INC PS

Practice address

6412 20TH Street CT W
Fircrest, WA 98466-6227

Phone

(253) 566-8800

Fax

(253) 566-7092

NPI assigned

Jan 12, 2009

Last updated

Aug 2, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Warren Wakeland, B.A., D.C.NPI 1912055328

Title

President

Phone

(253) 566-8800

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Warren Wakeland, BA DC

  • Chiropractor
  • Fircrest, WA
  • NPI 1912055328
  Medicare reassignment NPD Authorized official
• Jean Marie Scarzello Wakeland, BS DC

  • Chiropractor
  • Fircrest, WA
  • NPI 1568510972
  Medicare reassignment NPD

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1174760201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET CT W",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET CT W",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKELAND CHIROPRACTIC CENTER INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "WAKELAND",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-566-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "B.A., D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002197",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR & INDUSTRIES",
            "identifier": "53870",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T86908",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U27683",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Good Life Institute, LLC
• Nicole Kimberly Tjakralaksana
• University Place Pediatric Clinic P S
• Michelle Lea Vanaken, LMHC
• Christina Marie Vancamp, LMP
• Robert Warren Wakeland, BA DC
• Jason Wang, C.A., DIPL. AC.
• Gregory T Wellman, DPT
• Darren Wenz, LICSW
• Edward L West, D.C.

• Chiropractor in Fircrest, WA
• Providers in Fircrest, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.