NPIMap

Organization Active NPI

Advanced Wellness & Rehabilitation PLLC

  • Chiropractor
  • Silverdale, WA
National Provider Identifier
1700390267
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0005183762 Issued in WA
Legal business name
ADVANCED WELLNESS & REHABILITATION PLLC
Practice address
10513 Silverdale Way NW Ste 102
Silverdale, WA 98383-9499
Phone
(360) 698-4411
NPI assigned
Nov 20, 2017
Last updated
Nov 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Authorized official

Name
Darlene S Trebibski
Title
Office Manager
Phone
(360) 698-4411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0005183762 WA Primary

Addresses

Primary practice location

10513 Silverdale Way NW Ste 102
Silverdale, WA 98383-9499

Mailing address

10513 Silverdale Way NW Ste 102
Silverdale, WA 98383-9499
Phone (360) 698-4411

Other identifiers 1

IdentifierTypeStateIssuer
G8912636MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1700390267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10513 SILVERDALE WAY NW STE 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839499",
            "telephone_number": "360-698-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 SILVERDALE WAY NW STE 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839499",
            "telephone_number": "360-698-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WELLNESS & REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "TREBIBSKI",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-698-4411"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "DC0005183762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G8912636",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.