Mustafa Muhammad Idris, DC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

CH60261762 Issued in WA

Practice address

3925 159TH Ave NE
Building 21
Redmond, WA 98052-6309

Phone

(425) 216-0550

Fax

(425) 216-0552

NPI assigned

Nov 26, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thomas Wayne PLLC

  • Chiropractor
  • Burien, WA
  • NPI 1962694224
  NPD

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1851635122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18525 NE 58TH CT",
            "address_2": "APT N2105",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526708",
            "telephone_number": "425-638-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 159TH AVE NE",
            "address_2": "BUILDING 21",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980526309",
            "telephone_number": "425-216-0550",
            "fax_number": "425-216-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDRIS",
        "first_name": "MUSTAFA",
        "middle_name": "MUHAMMAD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WA",
            "license": "CH60261762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Huynh, M.D.
• Phi Huynh, L.AC.
• Ilhwan Hwang, DO
• Melissa Karen Hyman, MA, LMHC, ATR
• Todd Stephen Hymel, M.S.A., LAC
• Maureen Elizabeth Ihle, LMP
• Sadaf Ijaz
• Rachel Shigeko Inabata, PHD
• Inbalance Spinal Health & Wellness Center PLLC
• Daphna Inbar Rosman

• Orthopedic Chiropractor in Redmond, WA
• Providers in Redmond, WA by specialty
• Orthopedic Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.