NPIMap

Organization Active NPI

Rucker Avenue Chiropractic Center, PS

  • Chiropractor
  • Everett, WA
National Provider Identifier
1821320813
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 60069990 Issued in WA
Legal business name
RUCKER AVENUE CHIROPRACTIC CENTER, PS
Practice address
3231 Rucker Ave Ste a
Everett, WA 98201-4224
Phone
(425) 252-3127
Fax
(425) 252-3128
NPI assigned
Feb 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Authorized official

Name
Dr. Leland Isip Patron, D.C.
Title
President/Chiropractor
Phone
(425) 252-3127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH 60069990 WA Primary

Addresses

Primary practice location

3231 Rucker Ave Ste a
Everett, WA 98201-4224

Mailing address

3231 Rucker Ave Ste a
Everett, WA 98201-4224
Phone (425) 252-3127

National Provider Directory

National Provider Directory

Locations

3231 Rucker Ave
Ste A
Everett, WA 98201
Phone (425) 252-3127

3231 Rucker Ave
Everett, WA 98201
Phone (425) 252-3127

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1821320813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 RUCKER AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014224",
            "telephone_number": "425-252-3127",
            "fax_number": "425-252-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 RUCKER AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014224",
            "telephone_number": "425-252-3127",
            "fax_number": "425-252-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUCKER AVENUE CHIROPRACTIC CENTER, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "PATRON",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "ISIP",
        "authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
        "authorized_official_telephone_number": "425-252-3127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH 60069990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.