NPIMap

Organization Active NPI

Integrum Healthcare LLC

  • Clinic/Center
  • Burien, WA
National Provider Identifier
1619268802
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
CH00034837 Issued in WA
Legal business name
INTEGRUM HEALTHCARE LLC
Practice address
15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3066
Phone
(206) 242-8211
Fax
(206) 242-0162
NPI assigned
Apr 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Authorized official

Name
Dr. Christopher J Walters, DCNPI 1164604849
Title
Chiropractor
Phone
(206) 242-8211

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
Clinic/Center 261Q00000X CH00034837 WA Primary

Addresses

Primary practice location

15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3066

Mailing address

15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3066
Phone (206) 242-8211

Other identifiers 1

IdentifierTypeStateIssuer
0274108OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000742 WA Part B Supplier - Clinic/Group Practice 3971789306 Receives reassigned benefits from 2 practitioners
Practice locations: Burien, WA

National Provider Directory

National Provider Directory

Locations

15811 Ambaum Blvd SW
Ste 110
Burien, WA 98166
Phone (206) 242-8211

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1619268802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15811 AMBAUM BLVD SW",
            "address_2": "SUITE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663066",
            "telephone_number": "206-242-8211",
            "fax_number": "206-242-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15811 AMBAUM BLVD SW",
            "address_2": "SUITE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663066",
            "telephone_number": "206-242-8211",
            "fax_number": "206-242-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRUM HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "206-242-8211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "CH00034837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0274108",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.