Individual provider Active NPI

Paphawee Chungtrakool, DC

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1609613124
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61579259 Issued in WA
Practice address
5901 Roosevelt Way NE Ste 101a
Seattle, WA 98105-2763
Phone
(206) 525-5664
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61579259 WA Primary

Addresses

Primary practice location

5901 Roosevelt Way NE Ste 101a
Seattle, WA 98105-2763

Mailing address

22020 NE 147TH St
Brush Prairie, WA 98606-5501
Phone (360) 947-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725000932 WA Practitioner - Chiropractic 2062958150 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH61579259WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Health Chiropractic Clinic, P.C. Chiropractor CurrentSince Nov 18, 2025 Accepting new patients
Long Chiropractic Center Chiropractor PastSince Sep 29, 2024 Accepting new patients

Locations

6307 NE 117th Ave
Ste C
Vancouver, WA 98662
Phone (360) 253-4285

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1609613124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22020 NE 147TH ST",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986065501",
            "telephone_number": "360-947-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 ROOSEVELT WAY NE STE 101A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981052763",
            "telephone_number": "206-525-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNGTRAKOOL",
        "first_name": "PAPHAWEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61579259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.