NPIMap

Organization Active NPI

Family Chiropractic at Salmon Creek Inc

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1407052350
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003002 Issued in WA
Legal business name
FAMILY CHIROPRACTIC AT SALMON CREEK INC
Practice address
11815 NE Highway 99
Ste a
Vancouver, WA 98686-4008
Phone
(360) 696-4405
Fax
(360) 696-0582
NPI assigned
Jun 26, 2007
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Dr. Harley O. Youngblood III, R.N. ,D.C.,F.I.C.P.ANPI 1346233103
Title
President
Phone
(360) 696-4405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00003002 WA Primary

Addresses

Primary practice location

11815 NE Highway 99
Ste a
Vancouver, WA 98686-4008

Mailing address

11815 NE Highway 99
Ste a
Vancouver, WA 98686-4008
Phone (360) 696-4405

Other identifiers 1

IdentifierTypeStateIssuer
0046659OtherWALABOR & INDUSTRIES

National Provider Directory

National Provider Directory

Locations

11815 NE Highway 99
Ste A
Vancouver, WA 98686
Phone (360) 696-4405

Practitioners & affiliated clinicians

Practitioners 6

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": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1407052350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11815 NE HIGHWAY 99",
            "address_2": "STE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864008",
            "telephone_number": "360-696-4405",
            "fax_number": "360-696-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11815 NE HIGHWAY 99",
            "address_2": "STE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864008",
            "telephone_number": "360-696-4405",
            "fax_number": "360-696-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC AT SALMON CREEK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "HARLEY",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-696-4405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "R.N. ,D.C.,F.I.C.P.A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0046659",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.