Paul a Mack DC PS Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

1883 Issued in WA

Legal business name

PAUL A MACK DC PS INC

Practice address

636 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Phone

(206) 542-7571

Fax

(206) 546-1795

NPI assigned

Jun 26, 2008

Last updated

Feb 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul A Mack, DCNPI 1689798886

Title

President

Phone

(206) 542-7571

Specialties & licenses 1

Addresses

Other names 1

• Shoreline Chiropractic Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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.

• Paul A Mack, DC

  • Nutrition Chiropractor
  • Shoreline, WA
  • NPI 1689798886
  Medicare reassignment Care Compare group NPD Authorized official
• Gregory Atticus Mack, D.C.

  • Chiropractor
  • Shoreline, WA
  • NPI 1902353188
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1740442193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-542-7571",
            "fax_number": "206-546-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-542-7571",
            "fax_number": "206-546-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A MACK DC PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-542-7571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "1883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ellen Simone Passloff, MD
• Carolyn Michelle Patel, PT, DPT
• Zina Patel
• Antonia Anja Rafaela Patten, MSW
• Adryenne Patterson, MSW, LICSWA, MHP
• Lara Paxton, LMP
• Peacehealth Networks on Demand, LLC (ZoomCare-Shoreline)
• Mary Elizabeth Peacock
• Jaycie Pearce, DC
• Yuji Anton Pearce, BA

• Health Service Clinic/Center in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.