Church Chiropractic Inc

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH3323 Issued in WA

Legal business name

CHURCH CHIROPRACTIC INC

Doing business as

Healthsource of Puyallup

Practice address

1703 S Meridian
Suite 301
Puyallup, WA 98371-7590

Phone

(253) 841-4425

NPI assigned

Jun 25, 2008

Last updated

Nov 6, 2014By 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. Michael L Church, DC

Title

President

Phone

(253) 841-4425

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HEALTHSOURCE OF PUYALLUP Doing business as

Locations

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1801057526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1272",
            "city": "SUMNER",
            "state": "WA",
            "postal_code": "983900250",
            "telephone_number": "253-841-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN",
            "address_2": "SUITE 301",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-841-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-841-4425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH3323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "169571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHSOURCE OF PUYALLUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Jaehoon Chung, O.D
• Michelle S. Chung, DMD
• Pei Jung Chung
• Sang Yoon Chung, DMD
• Nga Tu Chuong, PHARMD
• Eva Churu
• Claude A Ciancio, MSPT
• Benjamin R. Cichon, PA-C
• Gabriela Nicole Cintron
• Gabriele Hannah Cintron, DPT

• Rehabilitation Chiropractor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.