NPIMap

Organization Active NPI

Premier Chiropractic 4 PLLC

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1205028826
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034325 Issued in WA
Legal business name
PREMIER CHIROPRACTIC 4 PLLC
Practice address
1299 156TH Ave NE Ste 123
Bellevue, WA 98007-7562
Phone
(425) 614-4000
Fax
(425) 641-0880
NPI assigned
Aug 16, 2007
Organization subpart
Yes
Parent organization
PREMIER CHIROPRACTIC & MASSAGE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mrs. Lilly Hansen
Title
Office Manager
Phone
(425) 614-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034325 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA00013538 WA

Addresses

Primary practice location

1299 156TH Ave NE Ste 123
Bellevue, WA 98007-7562

Mailing address

1299 156TH Ave NE Ste 123
Bellevue, WA 98007-7562
Phone (425) 614-4000

Other identifiers 1

IdentifierTypeStateIssuer
602211018OtherWAUBI #

Other names 1

  • Pacific Village Chiropractic Former legal business name

National Provider Directory

National Provider Directory

Locations

1299 156th Ave NE
Ste 123
Bellevue, WA 98007
Phone (425) 614-4000

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1205028826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 156TH AVE NE STE 123",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980077562",
            "telephone_number": "425-614-4000",
            "fax_number": "425-641-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 156TH AVE NE STE 123",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980077562",
            "telephone_number": "425-614-4000",
            "fax_number": "425-641-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CHIROPRACTIC 4 PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER CHIROPRACTIC & MASSAGE, PLLC",
        "enumeration_date": "2007-08-16",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "LILLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-614-4000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034325",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00013538",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI #",
            "identifier": "602211018",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Village Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.