Individual provider Active NPI

Jacob Friedman, DC

  • Chiropractor
  • Gig Harbor, WA
National Provider Identifier
1851892178
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
60829023 Issued in WA
Practice address
11511 Canterwood Blvd NW
Suite #210
Gig Harbor, WA 98332-5818
Phone
(253) 432-4451
NPI assigned
Feb 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 60829023 WA Primary

Addresses

Primary practice location

11511 Canterwood Blvd NW
Suite #210
Gig Harbor, WA 98332-5818

Mailing address

17007 SE 261St St
Covington, WA 98042-8373
Phone (253) 278-8549

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205000716 WA Practitioner - Chiropractic 1052744042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11511 Canterwood Blvd
Suite 210
Gig Harbor, WA 98332-5818
Phone (253) 432-4451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60829023WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of Issaquah PLLC Chiropractor CurrentSince Oct 1, 2021 Accepting new patients
Friedman Chiropractic PLLC Chiropractor CurrentSince Jan 11, 2021 Accepting new patients

Locations

11511 Canterwood Blvd
Ste 210
Gig Harbor, WA 98332
Phone (253) 432-4451

72 E Sunset Way
Issaquah, WA 98027
Phone (425) 281-2006

Organizations & group practices 2

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": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1851892178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17007 SE 261ST ST",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428373",
            "telephone_number": "253-278-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "SUITE #210",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325818",
            "telephone_number": "253-432-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2021-02-11",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "60829023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.