NPIMap

Organization Active NPI

Nisqually Generations Healing Center

  • General Practice Physician
  • Olympia, WA
National Provider Identifier
1023995388
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NISQUALLY GENERATIONS HEALING CENTER
Practice address
3661 Pacific Ave SE
Olympia, WA 98501-2122
Phone
(360) 218-7970
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christopher Petrozzi
Title
Administrator
Phone
(360) 218-7970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3661 Pacific Ave SE
Olympia, WA 98501-2122

Mailing address

3661 Pacific Ave SE
Olympia, WA 98501-2122

National Provider Directory

National Provider Directory
Tax ID family
Nisqually Generations Healing Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1023995388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 PACIFIC AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 PACIFIC AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012122",
            "telephone_number": "360-218-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISQUALLY GENERATIONS HEALING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "PETROZZI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-218-7970"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.