Organization Active NPI

Island Wellness Resources PLLC

  • Medical Specialty Clinic/Center
  • Bainbridge Island, WA
National Provider Identifier
1932334778
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
CH60030711 Issued in WA
Legal business name
ISLAND WELLNESS RESOURCES PLLC
Practice address
15445 Sunrise Drive NE
Bainbridge Island, WA 98110
Phone
(206) 842-6714
Fax
(206) 842-1667
NPI assigned
May 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Dr. Christine A. Grams, DC
Title
Chiropractor/Business Owner
Phone
(206) 842-6714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X CH60030711 WA Primary

Addresses

Primary practice location

15445 Sunrise Drive NE
Bainbridge Island, WA 98110

Mailing address

321 High School Road NE
Suite D-3, PMB 378
Bainbridge Island, WA 98110
Phone (206) 842-6714

Other identifiers 1

IdentifierTypeStateIssuer
602855045OtherWAUNIFIED BUSINESS ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090624000502 WA Part B Supplier - Clinic/Group Practice 0345391710 Receives reassigned benefits from 1 practitioner
Practice locations: Bainbridge Island, WA

National Provider Directory

National Provider Directory

Locations

149 Finch Pl SW
Ste 1
Bainbridge Island, WA 98110
Phone (206) 842-6714

Practitioners & affiliated clinicians

Practitioners 3

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": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1932334778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 HIGH SCHOOL ROAD NE",
            "address_2": "SUITE D-3, PMB 378",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6714",
            "fax_number": "206-842-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15445 SUNRISE DRIVE NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6714",
            "fax_number": "206-842-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND WELLNESS RESOURCES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "GRAMS",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIROPRACTOR/BUSINESS OWNER",
        "authorized_official_telephone_number": "206-842-6714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "CH60030711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFIED BUSINESS ID",
            "identifier": "602855045",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.