Individual provider Active NPI

Kierra Mielle Smith

  • Chiropractor
  • Shoreline, WA
National Provider Identifier
1780206243
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61116941 Issued in WA
Practice address
20126 Ballinger Way NE # 339
Shoreline, WA 98155-1117
Phone
(206) 920-9473
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61116941 WA Primary

Addresses

Primary practice location

20126 Ballinger Way NE # 339
Shoreline, WA 98155-1117

Mailing address

20126 Ballinger Way NE # 339
Shoreline, WA 98155-1117
Phone (206) 920-9473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221230001925 WA Practitioner - Chiropractic 6002286374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearview Wellness Center PLLCGroup PAC ID 7517193287, 3 clinicians

Practice addresses (Care Compare)

17416 Sr
9 Suite B
Snohomish, WA 98296-6304
Phone (360) 668-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Wellness Center, PLLC Chiropractor CurrentSince Apr 4, 2025 Accepting new patients
Lake Union Wellness, PS Chiropractor PastSince Dec 1, 2022 Accepting new patients
Lieberman Family Chiropractic Chiropractor PastSince Nov 6, 2022 Accepting new patients

Locations

17416 State Route 9 SE
Ste B
Snohomish, WA 98296
Phone (360) 668-2000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1780206243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20126 BALLINGER WAY NE # 339",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551117",
            "telephone_number": "206-920-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20126 BALLINGER WAY NE # 339",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551117",
            "telephone_number": "206-920-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIERRA",
        "middle_name": "MIELLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61116941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.

Verify at the official NPI Registry.