Provider Demographics
NPI:1730060526
Name:C1 RENTON PLLC
Entity type:Organization
Organization Name:C1 RENTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-753-4206
Mailing Address - Street 1:3459 S 152ND ST
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3459 S 152ND ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2176
Practice Address - Country:US
Practice Address - Phone:206-241-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty