Active NPI
Brian Evan Hardesty, DOCTOR OF CHIROPRACT
- Chiropractor
- Marysville, WA
National Provider Identifier
1952464299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1967
- Practice address
- 6031 B 47TH Ave NE
Marysville, WA 98270 - Phone
- (360) 653-2312
- Fax
- (360) 653-9055
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1967 | WA | Primary |
Addresses
Primary practice location
6031 B 47TH Ave NE
Marysville, WA 98270
Mailing address
PO Box 295
Marysville, WA 98270
Phone (360) 653-2312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1967 | WA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952464299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 295",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "98270",
"telephone_number": "360-653-2312",
"fax_number": "360-653-9055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6031 B 47TH AVE NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "98270",
"telephone_number": "360-653-2312",
"fax_number": "360-653-9055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDESTY",
"first_name": "BRIAN",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "DOCTOR OF CHIROPRACT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "1967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.