Onsite Doctors, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

603284445 Issued in WA

Legal business name

ONSITE DOCTORS, LLC

Doing business as

Boardwalk Chiropractic

Practice address

1800 SE Columbia River Dr.
Vancouver, WA 98661

Phone

(360) 953-4211

NPI assigned

May 2, 2014

Last updated

May 2, 2014By 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

Carolynn Jean Pavlock, DC

Title

Chiropractor, Owner

Phone

(360) 953-4211

Specialties & licenses 1

Addresses

Other names 1

• Boardwalk Chiropractic Doing business as

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1265842041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17811 NE 20TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986849781",
            "telephone_number": "360-953-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE COLUMBIA RIVER DR.",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-953-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONSITE DOCTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "PAVLOCK",
        "authorized_official_first_name": "CAROLYNN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CHIROPRACTOR, OWNER",
        "authorized_official_telephone_number": "360-953-4211",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "603284445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boardwalk Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinic/Center in Washington

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