Ellensburg Sport and Spine, LLC
NPI 1376215483ActiveOrganization· Chiropractor· Ellensburg, WA
Chiropractor in Ellensburg, Washington, registered in NPPES in September 2021. The authorized official on file is Dillon T. Clark, DC, Owner/Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376215483 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 28, 2021 |
| Last updated in NPPES | May 6, 2022 |
| Certified by provider | May 6, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|
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