NPIMap

Organization Active NPI

Gonstead Chiropractic of Seattle PC

  • Chiropractor
  • Tukwila, WA
National Provider Identifier
1346738408
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60502337 Issued in WA
Legal business name
GONSTEAD CHIROPRACTIC OF SEATTLE PC
Practice address
13028 Interurban Ave S Ste 106
Tukwila, WA 98168-3340
Phone
(206) 957-7950
Fax
(206) 957-7952
NPI assigned
Apr 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Authorized official

Name
Dr. Kendra L Buchholz, DCNPI 1639485279
Title
President
Phone
(206) 957-7950

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH60502337 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA60036391 WA

Addresses

Primary practice location

13028 Interurban Ave S Ste 106
Tukwila, WA 98168-3340

Mailing address

13028 Interurban Ave S Ste 106
Tukwila, WA 98168-3340
Phone (206) 957-7950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180522000549 WA Part B Supplier - Clinic/Group Practice 8426313404 Receives reassigned benefits from 3 practitioners
Practice locations: Tukwila, WA

National Provider Directory

National Provider Directory

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": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1346738408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13028 INTERURBAN AVE S STE 106",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981683340",
            "telephone_number": "206-957-7950",
            "fax_number": "206-957-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13028 INTERURBAN AVE S STE 106",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981683340",
            "telephone_number": "206-957-7950",
            "fax_number": "206-957-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONSTEAD CHIROPRACTIC OF SEATTLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "BUCHHOLZ",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-957-7950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60502337",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60036391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.