NPIMap

Organization Active NPI

Manual Medicine & Rehabilitation Center PC

Doing business as Dr.Ibolit

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1295900421
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034303 Issued in WA
Legal business name
MANUAL MEDICINE & REHABILITATION CENTER PC
Doing business as
Dr.Ibolit
Practice address
221A NE 104TH Ave Ste 205
Vancouver, WA 98664-4539
Phone
(360) 737-9665
Fax
(360) 737-9634
NPI assigned
Apr 29, 2008
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Aldona L PattersonNPI 1023826401
Title
Billing
Phone
(360) 737-9665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00034303 WA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00033960 WA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA00020024 WA

Addresses

Primary practice location

221A NE 104TH Ave Ste 205
Vancouver, WA 98664-4539

Mailing address

221A NE 104TH Ave Ste 205
Vancouver, WA 98664-4539
Phone (360) 737-9665

Other names 1

  • Dr.Ibolit Doing business as

National Provider Directory

National Provider Directory

Locations

5000 E Fourth Plain Blvd
Ste E104
Vancouver, WA 98661
Phone (360) 737-9665

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1295900421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221A NE 104TH AVE STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644539",
            "telephone_number": "360-737-9665",
            "fax_number": "360-737-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221A NE 104TH AVE STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644539",
            "telephone_number": "360-737-9665",
            "fax_number": "360-737-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUAL MEDICINE & REHABILITATION CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ALDONA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "360-737-9665"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034303",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033960",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00020024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr.Ibolit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.