Organization Active NPI

Shantijoy Inc

  • Naturopath
  • Everett, WA
National Provider Identifier
1306384300
Registry record updated Apr 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT60477240 Issued in WA
Legal business name
SHANTIJOY INC
Practice address
5208 S 2ND Ave
Everett, WA 98203
Phone
(425) 595-5892
Fax
(425) 595-5893
NPI assigned
Feb 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2017

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

Authorized official

Name
Dr. Aubrey K Wallace, ND
Title
Owner
Phone
(425) 595-5892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 175F00000X NT60477240 WA Primary

Addresses

Primary practice location

5208 S 2ND Ave
Everett, WA 98203

Mailing address

5208 S 2ND Ave
Everett, WA 98203
Phone (425) 595-5892

Other identifiers 1

IdentifierTypeStateIssuer
2046966MedicaidWA

Other names 1

  • ShantiJOY Integrative Doing business as

National Provider Directory

National Provider Directory

Locations

5208 S 2nd Ave
Everett, WA 98203
Phone (425) 595-5892

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492300800000",
    "number": "1306384300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 S 2ND AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98203",
            "telephone_number": "425-595-5892",
            "fax_number": "425-595-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 S 2ND AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98203",
            "telephone_number": "425-595-5892",
            "fax_number": "425-595-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTIJOY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-04-16",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "AUBREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-595-5892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60477240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046966",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShantiJOY Integrative",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2017; 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.