DR. ELENA PEDERSEN (NPI# 1003977703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003977703 |
| Entity Type | Individual |
| Full Name | DR. ELENA PEDERSEN |
| Credential | D.C. |
| Practice Address |
424 Williams Street Mossyrock WA 98564-0146 |
| Mailing Address |
Po Box 146 424 Williams St Mossyrock WA 98564-0146 |
| Practice Telephone | 3609838700 |
| Practice Fax Number | 3609838507 |
| Mailing Telephone | 3609838700 |
| Mailing Fax Number | 3609838507 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-02-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH00003066 | WA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | FEDERAL TAX ID | 911701042 | 01 |
| WA | LABOR AND INDUSTRIES ID | 108857 | 01 |
| Street Address |
424 WILLIAMS STREET |
| City | MOSSYROCK |
| State | WA |
| Zip Code | 98564-0146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508099011 | Emma Catherine Ferguson | Acupuncturist | 424 Williams Street, Mossyrock, WA 98564-0000 | 2009-08-31 |
| 1649487935 | Stacy Dagnon | Massage Therapist | 424 Williams Street, Mossyrock, WA 98564 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154830362 | David Richard Baldwin | Counselor | 230 East State Street, Mossyrock, WA 98564 | 2017-09-20 |
| 1679090294 | Jack Otto Lehmann | Counselor | 230 E State St, Mossyrock, WA 98564 | 2017-08-24 |
| 1417106287 | Jill Michelle Bellino | Licensed Practical Nurse | 101 Hope St, Mossyrock, WA 98564 | 2008-09-16 |
| 1740462308 | Riffe Medical Center Inc. | Family Medicine | 745 Williams St., Mossyrock, WA 98564 | 2007-12-05 |
| 1770791667 | Bonnie Carey | Acupuncturist | 242 E State St, Mossyrock, WA 98564 | 2007-05-21 |
| 1851489421 | Kevin W. Mccurry | Family Medicine | 745 Williams Street, Mossyrock, WA 98564 | 2006-10-10 |
| 1770518847 | Mossyrock School District | Local Education Agency (LEA) | 545 Williams St., Mossyrock, WA 98564 | 2006-07-11 |
| 1598737611 | Mossyrock Emergency Services | Ambulance | 137 E Main St, Mossyrock, WA 98564 | 2006-02-02 |
| 1184908410 | Lewis County Hospital District No 1 | Family Medicine | 745 Williams Street, Mossyrock, WA 98564 | 2011-10-05 |
| 1205110830 | Lewis County Hospital District No 1 | Clinic/Center | 745 Williams Street, Mossyrock, WA 98564 | 2011-09-30 |
| Find all providers in zip 98564 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972864395 | Alchemy Enterprises Inc | Chiropractor | 424 Williams St, Mossyrock, WA 98564-0146 | 2012-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416538 | Robert Martinez Molato | Chiropractor | 5106 Donnelly Dr Se, Olympia, WA 98501-5012 | 2020-10-26 |
| 1134726417 | Logan Chavez | Chiropractor | 1000 E Harvest Loop Apt 901, Ellensburg, WA 98926-5423 | 2020-10-08 |
| 1467059212 | Anderson Chiropractic Corporation, P.s. | Chiropractor | 6720 Regents Blvd Ste 108, University Place, WA 98466-5400 | 2020-10-05 |
| 1063019966 | Madison Allen | Chiropractor | 12339 Clubhouse Ln, Mukilteo, WA 98275-5577 | 2020-10-04 |
| 1528675527 | Joseph Gonzalez | Chiropractor | 1218 Ne 88th St Ste 108, Vancouver, WA 98665-9696 | 2020-09-24 |
| 1124633466 | Nolan Craig Ethridge | Chiropractor | 11515 Burnham Dr # 101, Gig Harbor, WA 98332-8543 | 2020-09-14 |
| 1235743402 | Caleb Mcinnis | Chiropractor | 18336 Aurora Ave N Ste 111, Shoreline, WA 98133-4526 | 2020-09-03 |
| 1174135925 | Brent Duncan | Chiropractor | 4813 Sw Walker St, Seattle, WA 98116-2149 | 2020-08-21 |
| 1336750900 | Hanchuan Ma | Chiropractor | 4744 41st Ave Sw Apt 415, Seattle, WA 98116-4568 | 2020-08-16 |
| 1285244079 | Wellness Group Pllc | Chiropractor | 2007 152nd Ave Ne Ste W, Redmond, WA 98052-5521 | 2020-08-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.