Organization Active NPI

Moore Chiropractic, PLLC

  • Rehabilitation Chiropractor
  • Olympia, WA
National Provider Identifier
1205247749
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH 60092035 Issued in WA
Legal business name
MOORE CHIROPRACTIC, PLLC
Practice address
221 Kenyon St NW Ste 201
221 Kenyon St NW Ste 201
Olympia, WA 98502-4552
Phone
(360) 352-0211
Fax
(360) 352-6226
NPI assigned
May 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Miss Robin Houde
Title
Office Manager
Phone
(360) 352-0211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X CH 60092035 WA Primary

Addresses

Primary practice location

221 Kenyon St NW Ste 201
221 Kenyon St NW Ste 201
Olympia, WA 98502-4552

Mailing address

1401 Marvin Rd NE
Lacey, WA 98516-5749
Phone (360) 491-5055

Other identifiers 1

IdentifierTypeStateIssuer
1821220369MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Moore Chiropractic PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1205247749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MARVIN RD NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165749",
            "telephone_number": "360-491-5055",
            "fax_number": "360-491-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 KENYON ST NW STE 201",
            "address_2": "221 KENYON ST NW STE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024552",
            "telephone_number": "360-352-0211",
            "fax_number": "360-352-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "HOUDE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-352-0211",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH 60092035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821220369",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.