Robert Warren Wakeland, BA DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00002197 Issued in WA

Practice address

6412 20TH Street Court West
Fircrest, WA 98466-6227

Phone

(253) 566-8800

Fax

(253) 566-7092

NPI assigned

Jan 8, 2007

Last updated

May 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wakeland Chiropractic Center Inc PS

  • Chiropractor
  • Fircrest, WA
  • NPI 1174760201
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1912055328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET COURT WEST",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 20TH STREET COURT WEST",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666227",
            "telephone_number": "253-566-8800",
            "fax_number": "253-566-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELAND",
        "first_name": "ROBERT",
        "middle_name": "WARREN",
        "credential": "BA DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "53871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Kimberly Tjakralaksana
• University Place Pediatric Clinic P S
• Michelle Lea Vanaken, LMHC
• Christina Marie Vancamp, LMP
• Wakeland Chiropractic Center Inc PS
• Jason Wang, C.A., DIPL. AC.
• Gregory T Wellman, DPT
• Darren Wenz, LICSW
• Edward L West, D.C.
• Kenneth Wheelock, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.