Individual provider Active NPI

Willson Chan, DC

  • Chiropractor
  • Everett, WA
National Provider Identifier
1669017760
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61001334 Issued in WA
Practice address
927 128TH St SW Ste B
Everett, WA 98204-6315
Phone
(425) 347-8614
NPI assigned
Nov 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61001334 WA Primary

Addresses

Primary practice location

927 128TH St SW Ste B
Everett, WA 98204-6315

Mailing address

927 128TH St SW Ste B
Everett, WA 98204-6315

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH61001334WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Everett Spine & Rehab, PLLC Chiropractor CurrentSince Jun 23, 2024 Accepting new patients

Locations

927 128th St SW
#B
Everett, WA 98204
Phone (425) 347-8614

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1669017760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 128TH ST SW STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 128TH ST SW STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046315",
            "telephone_number": "425-347-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "WILLSON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61001334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 12, 2019; 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.