CC SPORTS INJURY (NPI# 1699974048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699974048 |
| Entity Type | Organization |
| Organization Name | CC SPORTS INJURY |
| Practice Address |
7631 212th St Sw Ste 108c Edmonds WA 98026-7565 |
| Practice Telephone | 4257759601 |
| Practice Fax Number | 4257759608 |
| Mailing Telephone | 4257759601 |
| Mailing Fax Number | 4257759608 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |
| Authorized Official Name | DR. SEAN COREY SALAZAR (CEO) |
| Authorized Official Telephone | 4257759601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH34408 | WA | Chiropractic Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CC SPORTS INJURY LLC | 7631 212th St Sw Ste 105b, Edmonds, WA 98026-7565 |
| Street Address |
7631 212TH ST SW STE 108C |
| City | EDMONDS |
| State | WA |
| Zip Code | 98026-7565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891114476 | Sarah Landrum | Counselor | 7631 212th St Sw Ste 108c, Edmonds, WA 98026-7565 | 2014-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833526 | Enas Hamid Albar | Student in an Organized Health Care Education/Training Program | 7500 212th Street S.w., Suite 205, Edmonds, WA 98026 | 2020-08-26 |
| 1215579453 | Kailey Anne Matulich | Technician | 21630 84th Ave W, Edmonds, WA 98026 | 2019-10-09 |
| 1154962124 | Steven M Weible | Technician | 21630 84th Ave, Edmonds, WA 98026 | 2019-10-01 |
| 1053767293 | Hyo Kyung Kim | Pharmacist | 22618 Hwy 99 Ste 109, Edmonds, WA 98026 | 2016-05-06 |
| 1679947956 | Lucilyn Lumio | Occupational Therapist | 21008 76th Avenue W, Edmonds, WA 98026 | 2015-11-24 |
| 1669844205 | Kathleen Schmitt | Pharmacist | 21601 76th Ave West, Edmonds, WA 98026 | 2015-10-22 |
| 1689087967 | Ronald Paul Meagher | Anesthesiology | 7305 173rd St Sw, Edmonds, WA 98026 | 2014-06-04 |
| 1598194342 | Allison Alberton | Surgery | 7315 212th St Sw Ste 201, Edmonds, WA 98026 | 2013-11-02 |
| 1356681019 | Tekle Zewolday Eysadik | Registered Nurse | 8102 - 226 St Sw, Edmonds, WA 98026 | 2013-02-18 |
| 1447557087 | Diane Taylor | Counselor | 20903 70th Ave W., Edmonds, WA 98026 | 2011-02-17 |
| Find all providers in zip 98026 | ||||
| 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 |
|---|---|---|---|---|
| 1982062030 | Haijo Song | Chiropractor | 22019 Highway 99 Ste A, Edmonds, WA 98026-8023 | 2016-02-03 |
| 1275998957 | Gregory Bowers | Chiropractor | 420 3rd Ave S Apt 5, Edmonds, WA 98020-3569 | 2015-12-22 |
| 1376936229 | Dr Kevin Leach Pllc | Chiropractor | 7500 212th St Sw Ste 110, Edmonds, WA 98026-7615 | 2015-03-16 |
| 1376781930 | Carelove Chiropractic Clinic, Inc. | Chiropractor | 22315 Hwy 99, #b, Edmonds, WA 98026-8003 | 2009-02-04 |
| 1316196421 | Matthew So | Chiropractor | 8325 212th St Sw Ste 103, Edmonds, WA 98026-7435 | 2008-09-12 |
| 1134319650 | Nash Chiropractic Ps | Chiropractor | 23303 Hwy 99 Ste G, Edmonds, WA 98026-8762 | 2007-07-31 |
| 1841319001 | Bongchoon Yi | Chiropractor | 22315 Highway 99, #b, Edmonds, WA 98026-8003 | 2007-03-28 |
| 1144375064 | Kwang K Lee | Chiropractor | 23830 Hwy 99 101, Edmonds, WA 98026 | 2007-01-23 |
| 1013078633 | Matthew D Nash | Chiropractor | 23303 Hwy 99, Ste G, Edmonds, WA 98026 | 2006-12-13 |
| 1467526277 | Matthew Kevin Waldron | Chiropractor | 22933 Highway 99, Edmonds, WA 98026-8468 | 2006-11-20 |
| Find all providers in EDMONDS | ||||
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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.