Individual provider Active NPI

Casey Campbell, DC

  • Chiropractor
  • Mercer Island, WA
National Provider Identifier
1770123689
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61489169 Issued in WA
Practice address
2630 77TH Ave SE Ste 102
Mercer Island, WA 98040-3085
Phone
(206) 946-1192
NPI assigned
Jan 8, 2020
Last updated
Jun 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR.0008134 CO
Chiropractor 111N00000X DC36135 CA
Chiropractor 111N00000X 15193 TX
Chiropractor 111N00000X CH61489169 WA Primary
Rehabilitation Chiropractor 111NR0400X 15193 TX

Addresses

Primary practice location

2630 77TH Ave SE Ste 102
Mercer Island, WA 98040-3085

Mailing address

PO Box 700688
San Antonio, TX 78270-0688
Phone (800) 404-6050

Other practice location 1

411 Fairview Ave N
Seattle, WA 98109-5316
Phone (206) 324-5433

Other identifiers 3

IdentifierTypeStateIssuer
DC36135OtherCACHIROPRACTIC LICENSE
15193OtherTXCHIROPRACTIC LICENSE
CH61489169OtherWACHIROPRACTIC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15193TXMDProfessional Counselor
DC36135CAMDChiropractor
CHR.0008134COMDChiropractor
CH61489169WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Siskar Health PLLC Chiropractor CurrentSince Nov 3, 2024 Accepting new patients
G.R.I.T. Chiropractic and Rehab LLC Chiropractor CurrentSince Jan 24, 2021 Accepting new patients
Orca Wellness Past Accepting new patients
Myodetox California PC Inc. Chiropractor PastSince Mar 1, 2022 Accepting new patients

Locations

2897 Mapleton Ave
Ste 700
Boulder, CO 80301
Phone (720) 713-9516

2630 77th Ave SE
Ste 102
Mercer Island, WA 98040
Phone (206) 922-2237

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1770123689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700688",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782700688",
            "telephone_number": "800-404-6050",
            "fax_number": "866-313-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 77TH AVE SE STE 102",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403085",
            "telephone_number": "206-946-1192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Fairview Ave N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981095316",
            "country_code": "US",
            "telephone_number": "206-324-5433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CASEY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0008134",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36135",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15193",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61489169",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "15193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC36135",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "15193",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CH61489169",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2025; 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.