Bonney Lake Chiropractic Inc, PS

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034053 Issued in WA

Legal business name

BONNEY LAKE CHIROPRACTIC INC, PS

Practice address

9925 214TH Ave E
Suite C
Bonney Lake, WA 98391-3910

Phone

(253) 862-6662

Fax

(253) 862-5553

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Scott Allan Sheridan, DCNPI 1477619427

Title

Chiropractor

Phone

(253) 862-6662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Allan Sheridan, DC

  • Chiropractor
  • Bonney Lake, WA
  • NPI 1477619427
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1932396785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 214TH AVE E",
            "address_2": "SUITE C",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983913910",
            "telephone_number": "253-862-6662",
            "fax_number": "253-862-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 214TH AVE E",
            "address_2": "SUITE C",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983913910",
            "telephone_number": "253-862-6662",
            "fax_number": "253-862-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNEY LAKE CHIROPRACTIC INC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "253-862-6662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby Virk DMD & Helena Skountrianos DDS, PLLC
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• Agrini Boken, PA-C
• Michelle Bolland, MS
• Boncoeur Counseling Services LLC
• Bonney Lake Clinical Massage LLC
• Bonney Lake Dental Center
• Bonney Lake Dental LLC
• Bonney Lake Family Dentistry, PLLC
• Bonney Lake Medical Center

• Chiropractor in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.