Individual provider Active NPI

Michael Christopher Manning, ND

  • Family Medicine Physician
  • Kenmore, WA
National Provider Identifier
1609398700
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NT61488702 Issued in WA
Practice address
18208 66TH Ave NE Ste 201
Kenmore, WA 98028-7949
Phone
(559) 972-1833
Fax
(425) 814-2783
NPI assigned
Jul 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X CA
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X NT61488702 WA Primary

Addresses

Primary practice location

18208 66TH Ave NE Ste 201
Kenmore, WA 98028-7949

Mailing address

300 N 130TH St Unit 5103
Seattle, WA 98133-7973
Phone (559) 972-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NT61488702WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1609398700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 130TH ST UNIT 5103",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981337973",
            "telephone_number": "559-972-1833",
            "fax_number": "425-814-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18208 66TH AVE NE STE 201",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980287949",
            "telephone_number": "559-972-1833",
            "fax_number": "425-814-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "NT61488702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.