NPIMap

Organization Active NPI

Edmonds Family Chiropractic LLC

  • Chiropractor
  • Edmonds, WA
National Provider Identifier
1841566759
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60036464 Issued in WA
Legal business name
EDMONDS FAMILY CHIROPRACTIC LLC
Practice address
8325 212TH St SW Ste 103
Edmonds, WA 98026-7435
Phone
(425) 776-4224
NPI assigned
Mar 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Authorized official

Name
Dr. Matthew So, D.C.NPI 1316196421
Title
Owner
Phone
(425) 776-4224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH60036464 WA Primary

Addresses

Primary practice location

8325 212TH St SW Ste 103
Edmonds, WA 98026-7435

Mailing address

8325 212TH St SW Ste 103
Edmonds, WA 98026-7435
Phone (425) 776-4224

Other names 1

  • Life is Motion Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120424000429 WA Part B Supplier - Clinic/Group Practice 9133381965 Receives reassigned benefits from 2 practitioners
Practice locations: Edmonds, WA

National Provider Directory

National Provider Directory

Locations

8325 212th St SW
Ste 103
Edmonds, WA 98026
Phone (425) 776-4224

Practitioners & affiliated clinicians

Practitioners 5

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": "1332633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1841566759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 212TH ST SW STE 103",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267435",
            "telephone_number": "425-776-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 212TH ST SW STE 103",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267435",
            "telephone_number": "425-776-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-25",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "SO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-776-4224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60036464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life is Motion",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.