Organization Active NPI

Blue Stone Chiropractic PS

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1255440087
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH34314 Issued in WA
Legal business name
BLUE STONE CHIROPRACTIC PS
Doing business as
Blue Stone Chiropractic
Practice address
620 Kirkland Way
Suite 105
Kirkland, WA 98033-6021
Phone
(425) 822-1859
Fax
(425) 822-2920
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Dr. Mark M Travers, DC
Title
President
Phone
(425) 822-1859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH34314 WA Primary

Addresses

Primary practice location

620 Kirkland Way
Suite 105
Kirkland, WA 98033-6021

Mailing address

620 Kirkland Way
Ste 105
Kirkland, WA 98033-6021
Phone (425) 822-1859

Other identifiers 1

IdentifierTypeStateIssuer
195357OtherWAL&I

Other names 1

  • Blue Stone Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

620 Kirkland Way
Ste 105
Kirkland, WA 98033
Phone (425) 614-9918

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1255440087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 KIRKLAND WAY",
            "address_2": "STE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336021",
            "telephone_number": "425-822-1859",
            "fax_number": "425-822-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 KIRKLAND WAY",
            "address_2": "SUITE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336021",
            "telephone_number": "425-822-1859",
            "fax_number": "425-822-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STONE CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "TRAVERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-822-1859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH34314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "195357",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Stone Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.