NPIMap

Organization Active NPI

Life Impact Chiropractic & Massage Clinic

  • Chiropractor
  • Marysville, WA
National Provider Identifier
1992074454
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
00034817 Issued in WA
Legal business name
LIFE IMPACT CHIROPRACTIC & MASSAGE CLINIC
Practice address
621 Beach Ave
Marysville, WA 98270-4527
Phone
(360) 658-8675
Fax
(360) 658-8675
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Joseph Hong, D.C.
Title
Chiropractic
Phone
(360) 658-8675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 00034817 WA Primary

Addresses

Primary practice location

621 Beach Ave
Marysville, WA 98270-4527

Mailing address

621 Beach Ave
Marysville, WA 98270-4527
Phone (360) 658-8675

National Provider Directory

National Provider Directory

Locations

621 Beach Ave
Marysville, WA 98270
Phone (360) 658-8675

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1992074454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 BEACH AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704527",
            "telephone_number": "360-658-8675",
            "fax_number": "360-658-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BEACH AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704527",
            "telephone_number": "360-658-8675",
            "fax_number": "360-658-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE IMPACT CHIROPRACTIC & MASSAGE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIROPRACTIC",
        "authorized_official_telephone_number": "360-658-8675",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "00034817",
            "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 Dec 29, 2011; 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.