NPIMap

Organization Active NPI

Woodway Chiropractic and Massage, P.S.

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1417098005
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002873 Issued in WA
Legal business name
WOODWAY CHIROPRACTIC AND MASSAGE, P.S.
Practice address
20015 Highway 99 Ste a
Lynnwood, WA 98036-6073
Phone
(425) 771-2225
Fax
(425) 670-8121
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark R. Fredrich, D.C.
Title
Clinic Manager
Phone
(425) 771-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00002873 WA Primary

Addresses

Primary practice location

20015 Highway 99 Ste a
Lynnwood, WA 98036-6073

Mailing address

20015 Highway 99 Ste a
Lynnwood, WA 98036-6073
Phone (425) 771-2225

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417098005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 HIGHWAY 99 STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366073",
            "telephone_number": "425-771-2225",
            "fax_number": "425-670-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20015 HIGHWAY 99 STE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366073",
            "telephone_number": "425-771-2225",
            "fax_number": "425-670-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWAY CHIROPRACTIC AND MASSAGE, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREDRICH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "425-771-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.