Puyallup Chiropractic Clinic is a medicare enrolled "Chiropractor" provider in Puyalluup, Washington. Their current practice location is
111 East Stewart Ave, Puyalluup, Washington. You can reach out to their office (for appointments etc.) via phone at
(253) 845-0543.
Puyallup Chiropractic Clinic is licensed to practice in Washington (license number CH00002891) and it also participates in the medicare program. Puyallup Chiropractic Clinic
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1164599601.
Healthcare Provider's Profile
| Full Name | Puyallup Chiropractic Clinic |
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| Type | Facility |
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| Speciality | Chiropractor |
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| Location | 111 East Stewart Ave, Puyalluup, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164599601
- Provider Enumeration Date: 11/29/2006
- Last Update Date: 01/16/2008
Medicare PECOS Information:
- PECOS PAC ID: 2567352099
- Enrollment ID: O20040318000564
Medical Identifiers
Medical identifiers for Puyallup Chiropractic Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1164599601 | NPI | - | NPPES |
| TE6127 | Other | WA | REGENCE BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | CH00002891 (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Puyallup Chiropractic Clinic acts as a billing entity for following providers:
| Provider Name | Kevin L Terry |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1477616811
PECOS PAC ID: 0547150070
Enrollment ID: I20120323000161 |
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| Provider Name | Tyson Lynn Terry |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1255728291
PECOS PAC ID: 1658691076
Enrollment ID: I20150526001225 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Puyallup Chiropractic Clinic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Puyallup Chiropractic Clinic
111 East Stewart Ave,
Puyallup, WA 98372
Ph: (253) 845-0543 | Puyallup Chiropractic Clinic
111 East Stewart Ave,
Puyalluup, WA 98372
Ph: (253) 845-0543 |
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