NPIMap

Organization Active NPI

Renaissance Family Chiropractic, PLLC.

  • Chiropractor
  • Everett, WA
National Provider Identifier
1548328826
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RENAISSANCE FAMILY CHIROPRACTIC, PLLC.
Practice address
2824 Grand Ave Ste 102
Everett, WA 98201-3482
Phone
(425) 257-0177
Fax
(425) 257-1088
NPI assigned
Dec 5, 2006
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. Jennifer Anne Wilson, D.C.
Title
Member
Phone
(425) 257-0177

Specialties & licenses 1

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

Addresses

Primary practice location

2824 Grand Ave Ste 102
Everett, WA 98201-3482

Mailing address

2824 Grand Ave Ste 102
Everett, WA 98201-3482
Phone (425) 257-0177

National Provider Directory

National Provider Directory

Locations

2824 Grand Ave
Ste 101
Everett, WA 98201
Phone (425) 257-0177

Practitioners & affiliated clinicians

Practitioners 5

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548328826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 GRAND AVE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013482",
            "telephone_number": "425-257-0177",
            "fax_number": "425-257-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 GRAND AVE STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013482",
            "telephone_number": "425-257-0177",
            "fax_number": "425-257-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE FAMILY CHIROPRACTIC, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-257-0177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, 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.