Healthcare Provider Details

I. General information

NPI: 1033037114
Provider Name (Legal Business Name): KEONI APARIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 E LAKE SAMMAMISH PKWY SE STE A
ISSAQUAH WA
98029-8925
US

IV. Provider business mailing address

6220 E LAKE SAMMAMISH PKWY SE STE A
ISSAQUAH WA
98029-8925
US

V. Phone/Fax

Practice location:
  • Phone: 425-829-1321
  • Fax:
Mailing address:
  • Phone: 425-829-1321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH.70133858
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: