Active NPI
Kelly E Breen, DC
- Chiropractor
- Poulsbo, WA
National Provider Identifier
1316014558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2687
- Practice address
- 19421 7TH Ave NE
Poulsbo, WA 98370 - Phone
- (360) 779-9032
- Fax
- (360) 779-5844
- NPI assigned
- Nov 30, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2687 | WA | Primary |
Addresses
Primary practice location
19421 7TH Ave NE
Poulsbo, WA 98370
Mailing address
PO Box 528
Poulsbo, WA 98370
Phone (360) 779-9032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2687 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316014558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 528",
"city": "POULSBO",
"state": "WA",
"postal_code": "98370",
"telephone_number": "360-779-9032",
"fax_number": "360-779-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19421 7TH AVE NE",
"city": "POULSBO",
"state": "WA",
"postal_code": "98370",
"telephone_number": "360-779-9032",
"fax_number": "360-779-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEN",
"first_name": "KELLY",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "2687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
- Pamala Jean Bowman, LMP
- Lorin Debora Boynton, MD
- Cynthia Marie Brady, CDPT
- Aaron Brake, LMP
- Stanton F Brand
- Lois Bresaw, MD INC PS
- Brian L and Jennifer W Thornton DDS PS (Poulsbo Dental Center)
- Brian L and Jennifer W Thornton DDS PS (Poulsbo Dental Center)
- Bridgely Care LLC (Heartbridge Care)
- Jordan Briggs
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.