NPIMap

Organization Active NPI

Natural Wellness Center, PS

  • Chiropractor
  • Federal Way, WA
National Provider Identifier
1679609176
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001877 Issued in WA
Legal business name
NATURAL WELLNESS CENTER, PS
Practice address
30821 Pacific Hwy S
Federal Way, WA 98003-4901
Phone
(253) 839-8608
Fax
(253) 941-6821
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

Name
Dr. Michael Kevin Kinnear, DCNPI 1033249214
Title
President
Phone
(253) 839-8608

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: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00001877 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

30821 Pacific Hwy S
Federal Way, WA 98003-4901

Mailing address

30821 Pacific Hwy S
Federal Way, WA 98003-4901
Phone (253) 839-8608

Other identifiers 1

IdentifierTypeStateIssuer
88915OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070524000112 WA Part B Supplier - Clinic/Group Practice 0547367690 Receives reassigned benefits from 4 practitioners
Practice locations: Federal Way, WA

National Provider Directory

National Provider Directory

Locations

1409 S 348th St
Ste D103
Federal Way, WA 98003
Phone (253) 839-8608

30821 Pacific Hwy S
Federal Way, WA 98003
Phone (253) 839-8608

Practitioners & affiliated clinicians

Practitioners 10

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1679609176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30821 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034901",
            "telephone_number": "253-839-8608",
            "fax_number": "253-941-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30821 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034901",
            "telephone_number": "253-839-8608",
            "fax_number": "253-941-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL WELLNESS CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "KINNEAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-839-8608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001877",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "88915",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.