Organization Active NPI

Link Chiropractic and Wellness PS Inc

Doing business as Seattle Neck and Back Pain Clinic

  • Chiropractor
  • Kent, WA
National Provider Identifier
1376266866
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LINK CHIROPRACTIC AND WELLNESS PS INC
Doing business as
Seattle Neck and Back Pain Clinic
Practice address
25854 108TH Ave SE
Kent, WA 98030-7737
Phone
(253) 852-2828
Fax
(253) 852-2830
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Dr. Nazariy Stetsyuk, DCNPI 1356933972
Title
Doctor of Chiropractic
Phone
(253) 852-2828

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
Chiropractor 111N00000X NU Primary
Massage Therapist 225700000X NU

Addresses

Primary practice location

25854 108TH Ave SE
Kent, WA 98030-7737

Mailing address

25854 108TH Ave SE
Kent, WA 98030-7737
Phone (253) 852-2828

Other identifiers 3

IdentifierTypeStateIssuer
0440200OtherWALNI
NPIOtherWA1356933972
CHIROPRACTICLICENSEOtherWACH61135059

Other names 1

  • Seattle Neck and Back Pain Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Chiro8000 Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1376266866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25854 108TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307737",
            "telephone_number": "253-852-2828",
            "fax_number": "253-852-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25854 108TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307737",
            "telephone_number": "253-852-2828",
            "fax_number": "253-852-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINK CHIROPRACTIC AND WELLNESS PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "STETSYUK",
        "authorized_official_first_name": "NAZARIY",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "253-852-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "0440200",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1356933972",
            "identifier": "NPI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CH61135059",
            "identifier": "CHIROPRACTICLICENSE",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Chiro8000",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "25854 108th Ave SE",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980307737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Seattle Neck and Back Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.