NPIMap

Organization Active NPI

Mill Creek Wellness Center, PS

Doing business as Mill Creek Wellness Center

  • Chiropractor
  • Mill Creek, WA
National Provider Identifier
1336267194
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MILL CREEK WELLNESS CENTER, PS
Doing business as
Mill Creek Wellness Center
Practice address
15418 Main Street
Suite M106
Mill Creek, WA 98012-9021
Phone
(425) 742-6034
Fax
(425) 742-6035
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Dr. Jeff M Holt, D.C.NPI 1023172319
Title
Owner/Chiropractor
Phone
(425) 742-6034

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X WA Primary

Addresses

Primary practice location

15418 Main Street
Suite M106
Mill Creek, WA 98012-9021

Mailing address

15418 Main Street
Suite M106
Mill Creek, WA 98012-9021
Phone (425) 742-6034

Other names 1

  • Mill Creek Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008001015 WA Part B Supplier - Clinic/Group Practice 8921067489 Receives reassigned benefits from 3 practitioners
Practice locations: Mill Creek, WA

National Provider Directory

National Provider Directory
Tax ID family
Mill Creek Wellness Center2 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

15418 Main St
Unit M106
Mill Creek, WA 98012
Phone (425) 742-6034

800 164th St SE
Ste N
Mill Creek, WA 98012
Phone (425) 319-1123

Practitioners & affiliated clinicians

Practitioners 11

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1336267194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 MAIN STREET",
            "address_2": "SUITE M106",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129021",
            "telephone_number": "425-742-6034",
            "fax_number": "425-742-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN STREET",
            "address_2": "SUITE M106",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129021",
            "telephone_number": "425-742-6034",
            "fax_number": "425-742-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK WELLNESS CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "425-742-6034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Creek Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mill Creek Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.