NPIMap

Organization Active NPI

Functional Health Consulting, LLC

Doing business as Vida Integrated Health

  • Rehabilitation Chiropractor
  • Everett, WA
National Provider Identifier
1619226891
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CH60126824 Issued in WA
Legal business name
FUNCTIONAL HEALTH CONSULTING, LLC
Doing business as
Vida Integrated Health
Practice address
15 SW Everett Mall Way Ste G
Everett, WA 98204-2715
Phone
(425) 355-5222
Fax
(425) 355-5231
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Kris A Sasaki, D.C.NPI 1043465628
Title
Owner
Phone
(206) 726-9595

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
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X CH60126824 WA Primary

Addresses

Primary practice location

15 SW Everett Mall Way Ste G
Everett, WA 98204-2715

Mailing address

15 SW Everett Mall Way Ste G
Everett, WA 98204-2715
Phone (425) 355-5222

Other names 1

  • Vida Integrated Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000928 WA Part B Supplier - Clinic/Group Practice 1759560709 Receives reassigned benefits from 41 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Seattle, WA; Renton, WA; Everett, WA; Bellevue, WA; Kirkland, WA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2314986Vida Integrated Health15 SW Everett Mall Way Ste G, Everett, WA 98204Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

606 120th Ave NE
Ste 100D
Bellevue, WA 98005

11901 NE Village Plz
Ste 261
Kirkland, WA 98034
Phone (425) 814-2800

13030 121st Way NE
Ste 102
Kirkland, WA 98034
Phone (425) 814-2800

2014 E Madison St
Ste 100
Seattle, WA 98122
Phone (206) 726-9551

2914 E Madison St
Ste 109
Seattle, WA 98112
Phone (206) 333-0564

4915 25th Ave NE
Ste 102
Seattle, WA 98105
Phone (206) 335-8783

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1619226891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5222",
            "fax_number": "425-355-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SW EVERETT MALL WAY STE G",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-355-5222",
            "fax_number": "425-355-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL HEALTH CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SASAKI",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-726-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH60126824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vida Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.