1. Home
  2. Directory
  3. Washington
  4. Camas
  5. Clinic Center
  6. NPI Profile
  7. NPI Record 1366003022

ACCENT CHIROPRACTIC & WELLNESS
Complete NPI Record 1366003022
Clinic/Center - Multi-Specialty in Camas, WA

NPI Status: Active since June 24, 2019

Contact Information

428 NE 4TH AVE
CAMAS, WA
ZIP 98607
Phone: (360) 834-7300
Fax: (360) 210-4345

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Business Practice Location Address Fax Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Authorized Official Last Name
  21. Authorized Official First Name
  22. Authorized Official Middle Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Is Organization Subpart
  28. Authorized Official Name Prefix Text
  29. Authorized Official Credential Text
  30. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1366003022. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1366003022
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider First Line Business Mailing Address: 428 NE 4TH AVE
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address City Name: CAMAS
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address State Name: WA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 986072128
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3608347300
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 428 NE 4TH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CAMAS
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address State Name: WA
The date that a record was last updated or changed.
Provider Business Practice Location Address Postal Code: 986072128
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address Country Code If outside U S : US
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Telephone Number: 3608347300
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3602104345
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/24/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 9/28/2021
The date that a record was last updated or changed.
Authorized Official Last Name: REYNOLDS
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: AMY
The first name of the authorized official.
Authorized Official Middle Name: ELIZABETH
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 3608347300
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QM1300X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: DC
NPI Certification Date: 9/28/2021