Organization Active NPI

Sequim Chiropractic Clinic, PC

  • Chiropractor
  • Sequim, WA
National Provider Identifier
1467650259
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003465 Issued in WA
Legal business name
SEQUIM CHIROPRACTIC CLINIC, PC
Practice address
625 N 5TH Ave Ste 1
Sequim, WA 98382-5062
Phone
(360) 681-2414
Fax
(360) 681-3279
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Robert D Bean, DC
Title
Owner
Phone
(360) 681-2414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00003465 WA Primary

Addresses

Primary practice location

625 N 5TH Ave Ste 1
Sequim, WA 98382-5062

Mailing address

625 N 5TH Ave Ste 1
Sequim, WA 98382-5062
Phone (360) 681-2414

Other identifiers 1

IdentifierTypeStateIssuer
2026219MedicaidWA

National Provider Directory

National Provider Directory

Locations

546 N 5th Ave
Sequim, WA 98382
Phone (360) 681-2414

625 N 5th Ave
Ste 1
Sequim, WA 98382
Phone (206) 451-4213

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1467650259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N 5TH AVE STE 1",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983825062",
            "telephone_number": "360-681-2414",
            "fax_number": "360-681-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 5TH AVE STE 1",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983825062",
            "telephone_number": "360-681-2414",
            "fax_number": "360-681-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUIM CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "BEAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-681-2414",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026219",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.