NPIMap

Organization Active NPI

360 Chiropractic PS

  • Health Maintenance Organization
  • Lacey, WA
National Provider Identifier
1053596650
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
602760406 Issued in WA
Legal business name
360 CHIROPRACTIC PS
Practice address
5101 Lacey Blvd SE
Lacey, WA 98503-2441
Phone
(360) 923-0360
Fax
(360) 923-1360
NPI assigned
Jan 2, 2008
Last updated
Mar 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Authorized official

Name
Dr. Stefanie Marie Olar, D.C.NPI 1285756452
Title
President
Phone
(360) 923-0360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 602760406 WA Primary

Addresses

Primary practice location

5101 Lacey Blvd SE
Lacey, WA 98503-2441

Mailing address

PO Box 8310
Lacey, WA 98509-8310
Phone (360) 923-0360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080201000578 WA Part B Supplier - Clinic/Group Practice 1052493780 Receives reassigned benefits from 2 practitioners
Practice locations: Lacey, WA

National Provider Directory

National Provider Directory

Locations

5101 Lacey Blvd SE
Lacey, WA 98503
Phone (360) 923-0360

5831 Lacey Blvd SE
Ste G
Lacey, WA 98503
Phone (360) 923-0360

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1053596650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8310",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985098310",
            "telephone_number": "360-923-0360",
            "fax_number": "360-923-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 LACEY BLVD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032441",
            "telephone_number": "360-923-0360",
            "fax_number": "360-923-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 CHIROPRACTIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "OLAR",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-923-0360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "WA",
            "license": "602760406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.