Individual provider Active NPI

Donald Wayne Olson, D.C.

  • Chiropractor
  • Auburn, WA
National Provider Identifier
1033274154
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1559 Issued in WA
Practice address
1020 A St SE
Suite 4
Auburn, WA 98002-6063
Phone
(253) 939-0909
Fax
(253) 939-1813
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1559 WA Primary

Addresses

Primary practice location

1020 A St SE
Suite 4
Auburn, WA 98002-6063

Mailing address

1020 A St SE
Suite 4
Auburn, WA 98002-6063
Phone (253) 939-0909

Other identifiers 2

IdentifierTypeStateIssuer
2032779MedicaidWA
8868653OtherWAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071029000653 WA Practitioner - Chiropractic 5294822888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1020 A St SE
Auburn, WA 98002-6063
Phone (253) 939-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Street Clinic of Chiropractic PLLC Chiropractor CurrentSince Nov 3, 2007 Accepting new patients

Locations

1020 A St SE
Ste 4
Auburn, WA 98002
Phone (253) 939-0909

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1033274154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 A ST SE",
            "address_2": "SUITE 4",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026063",
            "telephone_number": "253-939-0909",
            "fax_number": "253-939-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 A ST SE",
            "address_2": "SUITE 4",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026063",
            "telephone_number": "253-939-0909",
            "fax_number": "253-939-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DONALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "1559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2032779",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8868653",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.