Individual provider Active NPI

Jessica Rae Kindschi, DC

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1881457513
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
61498138 Issued in WA
Practice address
2402 Broadway St
Vancouver, WA 98663-3229
Phone
(360) 241-6630
Fax
(360) 567-0620
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 61498138 WA Primary

Addresses

Primary practice location

2402 Broadway St
Vancouver, WA 98663-3229

Mailing address

206 NE 126TH Ave Apt 85
Vancouver, WA 98684-0889
Phone (971) 413-3882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923001563 WA Practitioner - Chiropractic 1951842590 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61498138WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Olsen Chiropractic, LLC Chiropractor CurrentSince Aug 21, 2024 Accepting new patients

Locations

2402 Broadway St
Vancouver, WA 98663
Phone (360) 241-6630

Organizations & group practices 1

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1881457513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 NE 126TH AVE APT 85",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986840889",
            "telephone_number": "971-413-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 BROADWAY ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633229",
            "telephone_number": "360-241-6630",
            "fax_number": "360-567-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDSCHI",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "61498138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.