NPIMap

Organization Active NPI

Sky Chiropractic Bellevue PS Inc

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1598041139
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003526 Issued in WA
Legal business name
SKY CHIROPRACTIC BELLEVUE PS INC
Practice address
12505 Bel Red Rd Ste 107
Bellevue, WA 98005-2510
Phone
(425) 773-8553
NPI assigned
Oct 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Dr. Sky Boulom, DCNPI 1245459718
Title
Owner
Phone
(425) 773-8553

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH00003526 WA Primary

Addresses

Primary practice location

12505 Bel Red Rd Ste 107
Bellevue, WA 98005-2510

Mailing address

15608 18TH PL W
Lynnwood, WA 98087-8800
Phone (425) 773-8553

National Provider Directory

National Provider Directory

Locations

12505 NE Bel Red Rd
Ste 107
Bellevue, WA 98005
Phone (425) 773-8553

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": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1598041139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15608 18TH PL W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980878800",
            "telephone_number": "425-773-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 BEL RED RD STE 107",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052510",
            "telephone_number": "425-773-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY CHIROPRACTIC BELLEVUE PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BOULOM",
        "authorized_official_first_name": "SKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-773-8553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.