Mill Creek Spine and Injury, Inc., P.S.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MILL CREEK SPINE AND INJURY, INC., P.S.

Practice address

1112 76TH Ave NE
Lake Stevens, WA 98258-3201

Phone

(425) 344-6835

NPI assigned

Jun 21, 2017

Organization subpart

No

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

Authorized official

Name

Ryan L Doerge, DCNPI 1811182066

Title

Owner

Phone

(425) 280-9980

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 3

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

• Ryan Lloyd Doerge, DC

  • Chiropractor
  • Bothell, WA
  • NPI 1811182066
  Medicare reassignment Care Compare group NPD Authorized official
• Michael Young, DC

  • Chiropractor
  • Mill Creek, WA
  • NPI 1588305254
  Medicare reassignment Care Compare group NPD
• Kathryn Sordahl, LMT

  • Massage Therapist
  • Mill Creek, WA
  • NPI 1881171643
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982124046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 76TH AVE NE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982583201",
            "telephone_number": "425-344-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 76TH AVE NE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982583201",
            "telephone_number": "425-344-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK SPINE AND INJURY, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DOERGE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-280-9980",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mendonca
• Ashley Menzies, OTR/L
• Michael J Fleming
• Michael J Fleming OD LLC
• Jordynn Mackenzie Midkiff
• Anna Mobley, ICCE, CLC
• Momentum Clinic
• Jacki L Moon, LMT
• Kayla Moore
• Sarah Anne Moore, ATC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.