NPIMap

Organization Active NPI

Mill Creek Chiropractic Clinic, PS

  • Chiropractor
  • Mill Creek, WA
National Provider Identifier
1346392859
Registry record updated Oct 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001655 Issued in WA
Legal business name
MILL CREEK CHIROPRACTIC CLINIC, PS
Practice address
16212 Bothell Everett Hwy
Suite E
Mill Creek, WA 98012-1235
Phone
(425) 745-4430
Fax
(425) 745-3572
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2007

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

Authorized official

Name
Dr. David Lawrence Gilbertson, , D.C.
Title
President
Phone
(425) 745-4430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00001655 WA Primary

Addresses

Primary practice location

16212 Bothell Everett Hwy
Suite E
Mill Creek, WA 98012-1235

Mailing address

16212 Bothell Everett Hwy
Suite E
Mill Creek, WA 98012-1235
Phone (425) 745-4430

Other identifiers 2

IdentifierTypeStateIssuer
25059OtherWALABOR & INDUSTRIES
R70357OtherWAREGENCE INSURANCE COMPANY

National Provider Directory

National Provider Directory

Locations

16212 Bothell Hwy
Ste E
Mill Creek, WA 98012
Phone (425) 745-4430

Practitioners & affiliated clinicians

Practitioners 3

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191628800000",
    "number": "1346392859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16212 BOTHELL EVERETT HWY",
            "address_2": "SUITE E",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121235",
            "telephone_number": "425-745-4430",
            "fax_number": "425-745-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16212 BOTHELL EVERETT HWY",
            "address_2": "SUITE E",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121235",
            "telephone_number": "425-745-4430",
            "fax_number": "425-745-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK CHIROPRACTIC CLINIC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-10-06",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-745-4430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": ", D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "25059",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE INSURANCE COMPANY",
            "identifier": "R70357",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 6, 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.