Active NPI
Samantha Dee Clevenger, DC
- Rehabilitation Chiropractor
- Tumwater, WA
National Provider Identifier
1104154285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- CH60924395
- Practice address
- 2806 29TH Ave SW Ste a
Tumwater, WA 98512-6155 - Phone
- (360) 589-9733
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | CH60924395 | WA | Primary |
Addresses
Primary practice location
2806 29TH Ave SW Ste a
Tumwater, WA 98512-6155
Mailing address
7711 Atchinson LN SE
Olympia, WA 98513-5316
Phone (360) 589-9733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CH60924395 | Other | WA | CHIROPRACTIC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190325002233 | WA | Practitioner - Chiropractic | 9436499662 | Practice locations: Olympia, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1110 Jefferson St SE
Olympia, WA 98501-1419
Phone (360) 589-9733
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1104154285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7711 ATCHINSON LN SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985135316",
"telephone_number": "360-589-9733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2806 29TH AVE SW STE A",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985126155",
"telephone_number": "360-589-9733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVENGER",
"first_name": "SAMANTHA",
"middle_name": "DEE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "WA",
"license": "CH60924395",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTIC LICENSE",
"identifier": "CH60924395",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.