Dewilde Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DEWILDE CHIROPRACTIC INC

Doing business as

Liberty Bay Chiropractic

Practice address

19660 10TH Ave NE Ste B
Poulsbo, WA 98370-6579

Phone

(360) 779-7800

Fax

(360) 779-7060

NPI assigned

Aug 10, 2007

Last updated

Jun 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Macedo, DR.NPI 1083949887

Title

Owner

Phone

(360) 779-7800

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Liberty Bay Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Baxter Macedo, D.C.

  • Chiropractor
  • Vancouver, WA
  • NPI 1083949887
  Medicare reassignment Care Compare group NPD Authorized official
• Cassidy Alyson McCrea, DC

  • Chiropractor
  • Poulsbo, WA
  • NPI 1144934993
  Medicare reassignment Care Compare group NPD
• David J. Powell, DC

  • Chiropractor
  • Billings, MT
  • NPI 1447454053

  WA

  Medicare reassignment Care Compare group NPD
• Jennifer Anne Miller, LMT

  • Massage Therapist
  • Poulsbo, WA
  • NPI 1053965798
  NPD
• Ivy Lynn Marie Parker

  • Massage Therapist
  • Poulsbo, WA
  • NPI 1881324283
  NPD
• Kristina Dawn Bauduin, LMP

  • Massage Therapist
  • Poulsbo, WA
  • NPI 1558693754
  NPD (past)
• Diane Marie Bishop, LMT

  • Massage Therapist
  • Poulsbo, WA
  • NPI 1295329704
  NPD (past)
• Kandyse Ybarra Deam, LMP

  • Massage Therapist
  • Poulsbo, WA
  • NPI 1912204629
  NPD (past)
• Claudette Meno, LMP

  • Specialist
  • Poulsbo, WA
  • NPI 1194967125
  NPD (past)
• Amy Patawaran, LMP

  • Specialist
  • Poulsbo, WA
  • NPI 1063803153
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1922290279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19660 10TH AVE NE STE B",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706579",
            "telephone_number": "360-779-7800",
            "fax_number": "360-779-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19660 10TH AVE NE STE B",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706579",
            "telephone_number": "360-779-7800",
            "fax_number": "360-779-7060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19045 Hwy.305,",
            "address_2": "Suite 203",
            "address_purpose": "LOCATION",
            "city": "Poulsbo",
            "state": "WA",
            "postal_code": "98370",
            "country_code": "US",
            "telephone_number": "360-779-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEWILDE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "MACEDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-779-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0188295",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Bay Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kandyse Ybarra Deam, LMP
• Rebekah Phare Deitrich, LMHC
• Duane Robert Delong, D.C.
• Danaher Dempsey, PT
• Juliet Dewey, M.A., CCC-SLP
• Charles Thomas Dewilde, DC
• Sukhdeep Singh Dhaliwal, M.D., D.D.S.
• Dirmeyer Chiropractic Wellness Clinic
• Anne Doane, LAC
• Robert Keith Doane, LAC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.