NPIMap

Organization Active NPI

Ryan Coogan DC PS

Doing business as Eastside Spine and Wellness

  • Chiropractor
  • Kirkland, WA
National Provider Identifier
1942486857
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034000 Issued in WA
Legal business name
RYAN COOGAN DC PS
Doing business as
Eastside Spine and Wellness
Practice address
11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone
(425) 821-4600
Fax
(425) 821-4622
NPI assigned
Jan 10, 2008
Last updated
Jan 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dr. Ryan Sean Coogan, DCNPI 1669522504
Title
President
Phone
(425) 821-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034000 WA Primary

Addresses

Primary practice location

11902 97TH Ave NE
Kirkland, WA 98034-1882

Mailing address

11902 97TH Ave NE
Kirkland, WA 98034-1882
Phone (425) 821-4600

Other names 1

  • Eastside Spine and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060504000907 WA Part B Supplier - Clinic/Group Practice 9931119922 Receives reassigned benefits from 2 practitioners
Practice locations: Kirkland, WA

National Provider Directory

National Provider Directory

Locations

11902 97th Ave NE
Kirkland, WA 98034
Phone (425) 821-4600

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1942486857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11902 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341882",
            "telephone_number": "425-821-4600",
            "fax_number": "425-821-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11902 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341882",
            "telephone_number": "425-821-4600",
            "fax_number": "425-821-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN COOGAN DC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "COOGAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-821-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Spine and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.