NPIMap

Organization Active NPI

Park Chiropractic and Wellness Clinic

  • Chiropractor
  • Renton, WA
National Provider Identifier
1689058935
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60105742 Issued in WA
Legal business name
PARK CHIROPRACTIC AND WELLNESS CLINIC
Practice address
819 South 3Rd Street
Renton, WA 98057
Phone
(425) 687-2707
Fax
(206) 309-9063
NPI assigned
Jul 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Dr. Young Park, D.C.
Title
Chiropractor
Phone
(425) 687-2707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH60105742 WA Primary

Addresses

Primary practice location

819 South 3Rd Street
Renton, WA 98057

Mailing address

819 South 3Rd Street
Renton, WA 98057
Phone (425) 687-2707

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1689058935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 SOUTH 3RD STREET",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-687-2707",
            "fax_number": "206-309-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 SOUTH 3RD STREET",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98057",
            "telephone_number": "425-687-2707",
            "fax_number": "206-309-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CHIROPRACTIC AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "425-687-2707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60105742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.