Active NPI
Russell Martin Macdonald, DC
- Chiropractor
- Spokane, WA
National Provider Identifier
1629151402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH33968
- Practice address
- 12310 N Division
105
Spokane, WA 99218 - Phone
- (509) 466-1117
- Fax
- (509) 464-0578
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH33968 | WA | Primary |
Addresses
Primary practice location
12310 N Division
105
Spokane, WA 99218
Mailing address
12310 N Division
105
Spokane, WA 99218
Phone (509) 466-1117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2024917 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH33968 | WA | MD | Chiropractor |
| 4669 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1629151402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12310 N DIVISION",
"address_2": "105",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99218",
"telephone_number": "509-466-1117",
"fax_number": "509-464-0578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12310 N DIVISION",
"address_2": "105",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99218",
"telephone_number": "509-466-1117",
"fax_number": "509-464-0578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "RUSSELL",
"middle_name": "MARTIN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH33968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2024917",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.