Jeffrey Scott Petett, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHOOOO2306 Issued in WA

Practice address

10622 SE Carr Rd
Suite a
Renton, WA 98055-5824

Phone

(425) 277-2225

Fax

(425) 277-1591

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chiro One Wellness Center of Renton PLLC

  • Chiropractor
  • Renton, WA
  • NPI 1336914571
  NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1467536656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10622 SE CARR RD",
            "address_2": "SUITE A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555824",
            "telephone_number": "425-277-2225",
            "fax_number": "425-277-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10622 SE CARR RD",
            "address_2": "SUITE A",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555824",
            "telephone_number": "425-277-2225",
            "fax_number": "425-277-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETETT",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CHOOOO2306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "41194",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8427031",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "911597946",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryanna Yurie Peterson, LMP
• Natalie Peterson
• Stacey Debra Oberst Peterson, MS, RD
• Petett Chiropractic Clinic, Inc.
• Anne R Petett, D.C.
• Petrilli Chiropractic Services PS
• Brett John Petrilli, D.C.
• Cindy L Pettegrew, LMP
• Alyssa Petty, MA60430594
• Stephanie Pew, CCC-SLP

• Chiropractor in Renton, WA
• Providers in Renton, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.