Summit Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH60219210 Issued in WA

Legal business name

SUMMIT CHIROPRACTIC LLC

Practice address

831 12TH Ave
Longview, WA 98632-2403

Phone

(360) 575-9155

Fax

(360) 636-5009

NPI assigned

Jun 20, 2011

Organization subpart

No

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

Authorized official

Name

David Charles Dalgardno, D.C.

Title

Owner/Chiropractor

Phone

(360) 575-9155

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1619263555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322403",
            "telephone_number": "360-575-9155",
            "fax_number": "360-636-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322403",
            "telephone_number": "360-575-9155",
            "fax_number": "360-636-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "DALGARDNO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "360-575-9155",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60219210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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