NPIMap

Organization Active NPI

Redmond Back and Neck Pain Clinic

  • Chiropractor
  • Redmond, WA
National Provider Identifier
1427509579
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001859 Issued in WA
Legal business name
REDMOND BACK AND NECK PAIN CLINIC
Practice address
16440 NE 85TH St
Redmond, WA 98052-3613
Phone
(425) 885-9950
Fax
(425) 895-9766
NPI assigned
Oct 24, 2016
Last updated
Oct 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Authorized official

Name
Sharon T Wagener Dewolf, D.C.NPI 1245395276
Title
Owner
Phone
(425) 885-9950

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001859 WA Primary

Addresses

Primary practice location

16440 NE 85TH St
Redmond, WA 98052-3613

Mailing address

16440 NE 85TH St
Redmond, WA 98052-3613
Phone (425) 885-9950

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1427509579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16440 NE 85TH ST",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523613",
            "telephone_number": "425-885-9950",
            "fax_number": "425-895-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16440 NE 85TH ST",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523613",
            "telephone_number": "425-885-9950",
            "fax_number": "425-895-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDMOND BACK AND NECK PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "WAGENER DEWOLF",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-885-9950",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.