Spine Align Northwest P.C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SPINE ALIGN NORTHWEST P.C.

Doing business as

Spine Align Northwest

Practice address

262 N 1St St Ste 1
Kalama, WA 98625-9100

Phone

(360) 673-9555

NPI assigned

Oct 6, 2021

Organization subpart

No

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

Authorized official

Name

Jacob Stockton, DCNPI 1174077473

Title

Owner

Phone

(360) 673-9555

Specialties & licenses 1

Addresses

Other names 1

• Spine Align Northwest Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 2

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

• Jacob Stockton, D.C.

  • Chiropractor
  • Kalama, WA
  • NPI 1174077473
  Medicare reassignment Care Compare group NPD Authorized official
• Aleksander Peter Rybar, DC

  • Chiropractor
  • Vancouver, WA
  • NPI 1336947662
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1679235766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1085",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986251000",
            "telephone_number": "360-600-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 N 1ST ST STE 1",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986259100",
            "telephone_number": "360-673-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE ALIGN NORTHWEST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "STOCKTON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-673-9555",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine Align Northwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Levin
• Tracie Lynn Payne, RN
• Colleen Emily Peterson, LMT
• Betsy Mae Preheim, LMP
• Colleen Marie Schaffer, LPN
• Jacob Stockton, D.C.
• Jon M Tippin, MD

• Health Service Clinic/Center in Kalama, WA
• Providers in Kalama, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.