Individual provider Active NPI

Kelila Kasim, D.C.

  • Nutrition Chiropractor
  • Tukwila, WA
National Provider Identifier
1992174866
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
60562994 Issued in WA
Practice address
15248 Sunwood Blvd
Tukwila, WA 98188-2444
Phone
(206) 261-7163
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 60562994 WA Primary

Addresses

Primary practice location

15248 Sunwood Blvd
Tukwila, WA 98188-2444

Mailing address

5429 Russell Ave NW
Seattle, WA 98107-4010
Phone (206) 782-8500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119001641 WA Practitioner - Chiropractic 4284045410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60562994WAMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Romney Chiropractic LLC CurrentSince May 26, 2022 Accepting new patients
CWC Group, PS CurrentSince Nov 1, 2020 Accepting new patients

Locations

12811 SE 38th St
Bellevue, WA 98006
Phone (425) 378-1800

24255 104th Ave SE
Kent, WA 98030
Phone (206) 289-0207

9701 South Tacoma Way
Ste 106
Lakewood, WA 98499
Phone (253) 588-8340

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1992174866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 RUSSELL AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074010",
            "telephone_number": "206-782-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15248 SUNWOOD BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882444",
            "telephone_number": "206-261-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASIM",
        "first_name": "KELILA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "WA",
            "license": "60562994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.