Active NPI
George Auttelet, D.C.
- Chiropractor
- Long Beach, WA
National Provider Identifier
1689761470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00002758
- Practice address
- 1108 12 TH South Pacific Hwy
Long Beach, WA 98631 - Phone
- (360) 642-8588
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00002758 | WA | Primary |
Addresses
Primary practice location
1108 12 TH South Pacific Hwy
Long Beach, WA 98631
Mailing address
PO Box 1460a
Long Beach, WA 98631-1440
Phone (360) 642-8588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110117000082 | WA | Practitioner - Chiropractic | 8123217593 | Practice locations: Long Beach, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1108 Pacific Ave S
Long Beach, WA 98631-3955
Phone (360) 642-8588
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": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689761470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1460A",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "986311440",
"telephone_number": "360-642-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 12 TH SOUTH PACIFIC HWY",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "98631",
"telephone_number": "360-642-8588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTTELET",
"first_name": "GEORGE",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH00002758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.