DR. JERRY WANG, D.C., P.S., INC. (NPI# 1053435214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053435214 |
| Entity Type | Organization |
| Organization Name | DR. JERRY WANG, D.C., P.S., INC. |
| Other Organization Name | EASTSIDE FAMILY CHIROPRACTIC |
| Practice Address |
1750 112th Ave Ne Ste C240 Bellevue WA 98004-5233 |
| Practice Telephone | 4256881994 |
| Practice Fax Number | 4256881990 |
| Mailing Telephone | 4256881994 |
| Mailing Fax Number | 4256881990 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2016-05-09 |
| Authorized Official Name | DR. JERRY WANG (PRESIDENT) |
| Authorized Official Telephone | 4256881994 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3517 | WA | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Eastside Family Chiropractic | Doing Business As Name - Organization |
| Street Address |
1750 112TH AVE NE STE C240 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-5233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740320795 | Jerry Wang | Chiropractor | 1750 112th Ave Ne Ste C240, Bellevue, WA 98004-5233 | 2007-02-07 |
| 1609236835 | Jeanie Gail | Massage Therapist | 1750 112th Ave Ne Ste C240, Bellevue, WA 98004-5233 | 2016-03-01 |
| 1992061857 | Randy A Schultz | Massage Therapist | 1750 112th Ave Ne Ste C240, Bellevue, WA 98004-5233 | 2012-04-04 |
| 1730222340 | Marina Chin | Massage Therapist | 1750 112th Ave Ne Ste C240, Bellevue, WA 98004-5233 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| 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 |
|---|---|---|---|---|
| 1225679830 | Emmalynne Splichal | Chiropractor | 3407 Birchwood Dr, Bellevue, NE 68123-2364 | 2019-10-04 |
| 1629639711 | Clarissa L Engen | Chiropractor | 2018 156th Ave Ne Ste 135, Bellevue, WA 98007-3825 | 2019-06-28 |
| 1982166682 | Wilhelm Bruno Von Eckroth | Chiropractor | 1800 116th Ave Ne Ste 101, Bellevue, WA 98004-3043 | 2019-04-02 |
| 1649734930 | Onepoint Chiropractic | Chiropractor | 4307 Factoria Blvd Se Ste 2, Bellevue, WA 98006-1936 | 2019-01-30 |
| 1417436429 | Hidden Valley Health LLC | Chiropractor | 1750 112th Ave Ne Ste A208, Bellevue, WA 98004-3765 | 2018-08-09 |
| 1295246080 | William Shiau | Chiropractor | 1407 116th Ave Ne Ste 104, Bellevue, WA 98004-3819 | 2017-10-19 |
| 1487163358 | Cameron Adam Lee | Chiropractor | 11212 Ne 36th Pl Apt E224, Bellevue, WA 98004-7997 | 2017-09-23 |
| 1053761999 | Youngjoo Koh | Chiropractor | 15350 Se 37th St Ste 100, Bellevue, WA 98006-1732 | 2016-06-21 |
| 1700246253 | Mitch Gottschalk | Chiropractor | 320 106th Ave Ne Suite A, Bellevue, WA 98004 | 2016-02-26 |
| 1720452535 | Bridget Walsh | Chiropractor | 735 Orchard Ave, Apt 6, Bellevue, PA 15202-3048 | 2015-11-17 |
| Find all providers in BELLEVUE | ||||
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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.