NPIMap

Organization Active NPI

Wang Wellness Clinic, P.S., Inc.

  • Chiropractor
  • Lynnwood, WA
National Provider Identifier
1902920408
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3517 Issued in WA
Legal business name
WANG WELLNESS CLINIC, P.S., INC.
Practice address
4629 168TH Street SW
STB
Lynnwood, WA 98037
Phone
(425) 688-1994
Fax
(425) 688-1990
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jerry Wang, D.C.
Title
President
Phone
(425) 688-1994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3517 WA Primary

Addresses

Primary practice location

4629 168TH Street SW
STB
Lynnwood, WA 98037

Mailing address

555 116TH Ave NE Ste 116
Bellevue, WA 98004-5233
Phone (425) 688-1994

National Provider Directory

National Provider Directory

Locations

4629 168th St SW
Lynnwood, WA 98037
Phone (425) 688-1994

Practitioners & affiliated clinicians

Practitioners 4

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902920408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 116TH AVE NE STE 116",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045233",
            "telephone_number": "425-688-1994",
            "fax_number": "425-688-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 168TH STREET SW",
            "address_2": "STB",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-688-1994",
            "fax_number": "425-688-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANG WELLNESS CLINIC, P.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-688-1994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.