Individual provider Active NPI

Elizabeth Joan Detwiler, D.C.

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1679605794
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034738 Issued in WA
Practice address
17720 SE Mill Plain Blvd Ste 160
Vancouver, WA 98683-7585
Phone
(360) 944-4437
Fax
(360) 944-3925
NPI assigned
Mar 12, 2007
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 CH00034738 WA Primary

Addresses

Primary practice location

17720 SE Mill Plain Blvd Ste 160
Vancouver, WA 98683-7585

Mailing address

17720 SE Mill Plain Blvd Ste 160
Vancouver, WA 98683-7585
Phone (360) 944-4437

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1679605794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17720 SE MILL PLAIN BLVD STE 160",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986837585",
            "telephone_number": "360-944-4437",
            "fax_number": "360-944-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 SE MILL PLAIN BLVD STE 160",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986837585",
            "telephone_number": "360-944-4437",
            "fax_number": "360-944-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "ELIZABETH",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.