Individual provider Active NPI

Allen Gordon Green, DC

  • Chiropractor
  • Woodinville, WA
National Provider Identifier
1669415956
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001603 Issued in WA
Practice address
17401 135TH Ave NE
#4
Woodinville, WA 98072
Phone
(425) 483-2320
Fax
(425) 424-3256
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001603 WA Primary

Addresses

Primary practice location

17401 135TH Ave NE
#4
Woodinville, WA 98072

Mailing address

17401 135TH Ave NE
#4
Woodinville, WA 98072
Phone (425) 483-2320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120821001064 WA Practitioner - Chiropractic 4789831009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17401 135TH Ave NE
Suite 4
Woodinville, WA 98072-6825
Phone (425) 483-2320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00001603WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center, Inc. Chiropractor CurrentSince Sep 1, 2012 Accepting new patients
Formo Enterprises, Inc Past Accepting new patients

Locations

17401 135th Ave NE
Ste 4
Woodinville, WA 98072
Phone (425) 483-2320

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669415956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17401 135TH AVE NE",
            "address_2": "#4",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-2320",
            "fax_number": "425-424-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 135TH AVE NE",
            "address_2": "#4",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-2320",
            "fax_number": "425-424-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALLEN",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.