Healthcare Provider Details

I. General information

NPI: 1174478499
Provider Name (Legal Business Name): DYNAMO CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 156TH AVE NE STE 215
BELLEVUE WA
98007-8457
US

IV. Provider business mailing address

1313 156TH AVE NE STE 215
BELLEVUE WA
98007-8457
US

V. Phone/Fax

Practice location:
  • Phone: 425-827-2225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JACOB LIPSKI
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 414-308-9975