Balanced Spine LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034301 Issued in WA

Legal business name

BALANCED SPINE LLC

Practice address

22525 SE 64TH PL
Suite 110
Issaquah, WA 98027-5383

Phone

(425) 369-1040

Fax

(425) 369-1041

NPI assigned

Jul 8, 2006

Last updated

Jun 8, 2011By 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. Sean J Fryer, DCNPI 1215989454

Title

Managing Member

Phone

(425) 369-1040

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 7

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.

• Sean Jackson Fryer, D.C.

  • Chiropractor
  • Issaquah, WA
  • NPI 1215989454
  Medicare reassignment NPD Authorized official
• Kelly Loranger, LMP

  • Specialist
  • Issaquah, WA
  • NPI 1215396965
  NPD (past)
• Justin Charles Schallmann, D.C.

  • Chiropractor
  • Redmond, WA
  • NPI 1114199676
  NPD (past)
• Maryn Amara Spangler, LMP

  • Massage Therapist
  • Issaquah, WA
  • NPI 1497113732
  NPD (past)
• Joshua Ryan Stehmeier, D.C.

  • Chiropractor
  • Issaquah, WA
  • NPI 1821274440
  NPD (past)
• Kimberly S White, D.C.

  • Chiropractor
  • Liberty Lake, WA
  • NPI 1124380589
  NPD (past)
• Haerang Grace Yu

  • Chiropractor
  • Issaquah, WA
  • NPI 1578880860
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1265465058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22525 SE 64TH PL",
            "address_2": "SUITE 110",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275383",
            "telephone_number": "425-369-1040",
            "fax_number": "425-369-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22525 SE 64TH PL",
            "address_2": "SUITE 110",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275383",
            "telephone_number": "425-369-1040",
            "fax_number": "425-369-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "FRYER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "425-369-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Bakeman
• Andrea Kay Baker, FNP-C
• Kailey Alexandra Baker, AT-C, OT-C
• Kimberly Sue Baker, PHARMD
• Balance Physical Therapy Inc, P.S.
• Perry Balcom
• Randy L Ball, D.M.D
• Rashida Ballard, MSW, LICSW, CDE
• Saige Danielle Ballard
• Banic Chiropractic Company (Banic Chiropractic Clinic)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.