NPIMap

Organization Active NPI

Pacific Highway Chiropractic

Doing business as Islam Wardak D.C

  • Chiropractor
  • Seatac, WA
National Provider Identifier
1467578534
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034030 Issued in WA
Legal business name
PACIFIC HIGHWAY CHIROPRACTIC
Doing business as
Islam Wardak D.C
Practice address
15245 International Blvd
Suite 210
Seatac, WA 98188-2146
Phone
(206) 923-7600
Fax
(206) 923-7601
NPI assigned
Mar 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Stacy R Smith
Title
Office Manager
Phone
(206) 923-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034030 WA Primary

Addresses

Primary practice location

15245 International Blvd
Suite 210
Seatac, WA 98188-2146

Mailing address

15245 International Blvd
Suite 210
Seatac, WA 98188-2146
Phone (206) 923-7600

Other names 1

  • Islam Wardak D.C Doing business as

National Provider Directory

National Provider Directory

Locations

15245 International Blvd
Ste 210
Seatac, WA 98188
Phone (206) 923-7600

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467578534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 INTERNATIONAL BLVD",
            "address_2": "SUITE 210",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981882146",
            "telephone_number": "206-923-7600",
            "fax_number": "206-923-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 INTERNATIONAL BLVD",
            "address_2": "SUITE 210",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981882146",
            "telephone_number": "206-923-7600",
            "fax_number": "206-923-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HIGHWAY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "206-923-7600"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Islam Wardak D.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seatac, 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.