Michael Pettet, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034021 Issued in WA

Practice address

11600 SE Mill Plain Blvd
Suite 3J
Vancouver, WA 98684-5083

Phone

(360) 253-6674

Fax

(360) 253-8670

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael B. Pettet, DC, PSGroup PAC ID 5597757658, 2 clinicians

Practice addresses (Care Compare)

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.

• Michael B. Pettet, DC, PS

  • Chiropractor
  • Vancouver, WA
  • NPI 1609086784
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1881647717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11516 SE MILL PLAIN BLVD",
            "address_2": "STE 2C",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845082",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 SE MILL PLAIN BLVD",
            "address_2": "SUITE 3J",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845083",
            "telephone_number": "360-253-6674",
            "fax_number": "360-253-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTET",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034021",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "283284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Petrik, RN
• Lyndsey Tyler Petrino
• Angelika M Petrova
• Anna M Petruolo, LMP
• Danielle Mariah Pettet, DC
• Tyler Jonathon Pettett, LMHCA
• Theron M Pettit, MD
• Daniel S Petty, DDS
• Tenli N Petty
• Christopher Pexton, D.O.

• Chiropractor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.