NPIMap

Organization Active NPI

Kent Chiropractic Clinic PS

  • Chiropractor
  • Seaview, WA
National Provider Identifier
1649318635
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001614 Issued in WA
Legal business name
KENT CHIROPRACTIC CLINIC PS
Practice address
4403 Pacific Highway
Seaview, WA 98644-0004
Phone
(360) 642-4390
NPI assigned
Feb 2, 2007
Last updated
Dec 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Mr. Gordon Raymond Kent, DC
Title
Chiropractor
Phone
(360) 642-4390

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 025202 WA
Chiropractor 111N00000X CH00001614 WA Primary

Addresses

Primary practice location

4403 Pacific Highway
Seaview, WA 98644-0004

Mailing address

PO Box D
Seaview, WA 98644-0004
Phone (360) 642-4390

Other identifiers 1

IdentifierTypeStateIssuer
0017594OtherWAL & I

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1649318635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX D",
            "city": "SEAVIEW",
            "state": "WA",
            "postal_code": "986440004",
            "telephone_number": "360-642-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 PACIFIC HIGHWAY",
            "city": "SEAVIEW",
            "state": "WA",
            "postal_code": "986440004",
            "telephone_number": "360-642-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT CHIROPRACTIC CLINIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "360-642-4390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "025202",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0017594",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.