Kelly Anne Sudore, R.N., B.S.N., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00033602 Issued in OR

Practice address

328 W Main St
Monroe, WA 98272-1812

Phone

(360) 794-4500

Fax

(360) 863-1640

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

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.

• Positive Chiropractic and Wellness

  • Chiropractor
  • Kirkland, WA
  • NPI 1427392836
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669512828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 W MAIN ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721812",
            "telephone_number": "360-794-4500",
            "fax_number": "360-863-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W MAIN ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721812",
            "telephone_number": "360-794-4500",
            "fax_number": "360-863-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDORE",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "R.N., B.S.N., D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "CH00033602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "402450",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Eunsoo Strohm, D.C.
• Scott Branting Strom, RPH
• Charles Roland Strub, MD
• Michelle Stupay
• Taylor Stutz
• April Suen, PHARMD
• Mitchell Hisao Suzawa, OT
• Krissy Marie Sweum Korneliussen
• Ganelle Swindler, SUDP
• Kenneth Warren Swinford, D.C.

• Chiropractor in Monroe, WA
• Providers in Monroe, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.