NPIMap

Organization Active NPI

Momentum Clinic

Doing business as Lake Stevens Chiropractic Clin

  • Chiropractor
  • Lake Stevens, WA
National Provider Identifier
1336850833
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MOMENTUM CLINIC
Doing business as
Lake Stevens Chiropractic Clin
Lake Stevens Chiropractic Clinic
Practice address
905 Sr 9
Lake Stevens, WA 98258-9484
Phone
(425) 334-5066
Fax
(425) 335-4787
NPI assigned
Dec 6, 2022
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

Name
Becky Johnson
Title
Office Manager
Phone
(425) 334-5066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

905 Sr 9
Lake Stevens, WA 98258-9484

Mailing address

905 Sr 9
Lake Stevens, WA 98258-9484
Phone (425) 334-5066

Other identifiers 1

IdentifierTypeStateIssuer
2041757MedicaidWA

Other names 2

  • Lake Stevens Chiropractic Clin Doing business as
  • Lake Stevens Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

905 State Route 9 NE
Lake Stevens, WA 98258
Phone (425) 334-5066

Practitioners & affiliated clinicians

Practitioners 5

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": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1336850833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SR 9",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982589484",
            "telephone_number": "425-334-5066",
            "fax_number": "425-335-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SR 9",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982589484",
            "telephone_number": "425-334-5066",
            "fax_number": "425-335-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-334-5066"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041757",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Stevens Chiropractic Clin",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Stevens Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Stevens, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.