NPIMap

Organization Active NPI

Jason Green, PLLC

  • Chiropractor
  • Snoqualmie, WA
National Provider Identifier
1669893418
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60090924 Issued in WA
Legal business name
JASON GREEN, PLLC
Practice address
7726 Center Blvd SE
Suite 125
Snoqualmie, WA 98065-8748
Phone
(425) 396-0613
Fax
(425) 396-0614
NPI assigned
Dec 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Dr. Jason Green, DCNPI 1275764284
Title
Owner
Phone
(425) 396-0613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH60090924 WA Primary
Pediatric ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NP0017X CH60070039 WA

Addresses

Primary practice location

7726 Center Blvd SE
Suite 125
Snoqualmie, WA 98065-8748

Mailing address

7726 Center Blvd SE
Suite 125
Snoqualmie, WA 98065-8748
Phone (425) 396-0613

Other names 1

  • Optimal Health Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140813001076 WA Part B Supplier - Clinic/Group Practice 3072730126 Receives reassigned benefits from 2 practitioners
Practice locations: Snoqualmie, WA

National Provider Directory

National Provider Directory

Locations

7726 Center Blvd SE
Ste 125
Snoqualmie, WA 98065
Phone (425) 396-0613

7726 Center Blvd SE
Ste 230
Snoqualmie, WA 98065
Phone (425) 396-0613

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1669893418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7726 CENTER BLVD SE",
            "address_2": "SUITE 125",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980658748",
            "telephone_number": "425-396-0613",
            "fax_number": "425-396-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7726 CENTER BLVD SE",
            "address_2": "SUITE 125",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980658748",
            "telephone_number": "425-396-0613",
            "fax_number": "425-396-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON GREEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-396-0613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60090924",
            "primary": true
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "WA",
            "license": "CH60070039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimal Health Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.