MEDICARE: EVOLVE CHIROPRACTIC STUDIO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1689512048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVOLVE CHIROPRACTIC STUDIO PLLC

Provider Business Mailing Address
First Line	:	406 BOSTON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2127
Country	:	US
Telephone Number	:	206-258-4489
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 BOSTON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-2127
Country	:	US
Telephone Number	:	206-258-4489
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN GOSLIN
Credential	:	DC
Telephone Number	:	206-258-4489

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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