NPIMap

Organization Active NPI

Marisa E Delisle, DC PS

Doing business as Northwest Family Chiropractic and Massage

  • Chiropractor
  • Shoreline, WA
National Provider Identifier
1326223900
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034271 Issued in WA
Legal business name
MARISA E DELISLE, DC PS
Doing business as
Northwest Family Chiropractic and Massage
Practice address
14709 Aurora Ave N
Shoreline, WA 98133-6547
Phone
(206) 363-4478
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Dr. Marisa Elizabeth De Lisle, DCNPI 1881744514
Title
Owner/President
Phone
(206) 363-4478

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00034271 WA Primary

Addresses

Primary practice location

14709 Aurora Ave N
Shoreline, WA 98133-6547

Mailing address

14709 Aurora Ave N
Shoreline, WA 98133-6547
Phone (206) 363-4478

Other names 1

  • Northwest Family Chiropractic and Massage Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060421000464 WA Part B Supplier - Clinic/Group Practice 5395755235 Receives reassigned benefits from 2 practitioners
Practice locations: Shoreline, WA

National Provider Directory

National Provider Directory
Tax ID family
Marisa E Delisle DC PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14709 Aurora Ave N
Shoreline, WA 98133
Phone (206) 363-4478

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1326223900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14709 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336547",
            "telephone_number": "206-363-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14709 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336547",
            "telephone_number": "206-363-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISA E DELISLE, DC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "DE LISLE",
        "authorized_official_first_name": "MARISA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "206-363-4478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Family Chiropractic and Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.