NPIMap

Organization Active NPI

Avant Chiropractic

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1336348572
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00033810 Issued in WA
Legal business name
AVANT CHIROPRACTIC
Practice address
3611 Woodland Park Ave N
Seattle, WA 98103-7905
Phone
(206) 826-1005
Fax
(206) 826-1289
NPI assigned
Jul 17, 2007
Last updated
Jul 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Dr. Michael Shane Mackinnon, DCNPI 1124192067
Title
Owner
Phone
(206) 826-1005

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
Chiropractor 111N00000X CH00033810 WA Primary

Addresses

Primary practice location

3611 Woodland Park Ave N
Seattle, WA 98103-7905

Mailing address

3611 Woodland Park Ave N
Seattle, WA 98103-7905
Phone (206) 826-1005

Other identifiers 1

IdentifierTypeStateIssuer
0173323OtherWALABOR & INDUSTRIES

National Provider Directory

National Provider Directory

Locations

3611 Woodland Park Ave N
Ste 100
Seattle, WA 98103
Phone (206) 826-1005

Practitioners & affiliated clinicians

Practitioners 12

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": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1336348572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 WOODLAND PARK AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037905",
            "telephone_number": "206-826-1005",
            "fax_number": "206-826-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 WOODLAND PARK AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037905",
            "telephone_number": "206-826-1005",
            "fax_number": "206-826-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "MACKINNON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-826-1005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0173323",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.

Verify at the official NPI Registry.