NPIMap

Organization Active NPI

Sunset Boulevard Chiropractic, P.S.

  • Chiropractor
  • Medical Lake, WA
National Provider Identifier
1962564294
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SUNSET BOULEVARD CHIROPRACTIC, P.S.
Practice address
725 N Stanley St
Ste. C
Medical Lake, WA 99022-8940
Phone
(509) 299-6900
Fax
(509) 299-6900
NPI assigned
Dec 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Christopher James Wellwood, D.C.NPI 1457413833
Title
Ceo
Phone
(509) 299-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

725 N Stanley St
Ste. C
Medical Lake, WA 99022-8940

Mailing address

725 N Stanley St
Ste. C
Medical Lake, WA 99022-8940
Phone (509) 299-6900

Other names 1

  • Sunset Boulevard Chiropractic Former legal business name

National Provider Directory

National Provider Directory

Locations

725 N Stanley St
Ste C
Medical Lake, WA 99022
Phone (509) 299-6900

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": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962564294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N STANLEY ST",
            "address_2": "STE. C",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228940",
            "telephone_number": "509-299-6900",
            "fax_number": "509-299-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N STANLEY ST",
            "address_2": "STE. C",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228940",
            "telephone_number": "509-299-6900",
            "fax_number": "509-299-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET BOULEVARD CHIROPRACTIC, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLWOOD",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-299-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Boulevard Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medical Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.