Individual provider Active NPI

Eddie Eufracio, PT, DPT

  • Physical Therapist
  • Lacey, WA
National Provider Identifier
1164214342
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.PT.61671859 Issued in WA
Practice address
8750 Tallon LN NE
Lacey, WA 98516-6608
Phone
(360) 456-1072
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT.PT.61671859 WA Primary

Addresses

Primary practice location

8750 Tallon LN NE
Lacey, WA 98516-6608

Mailing address

3800 Sleater Kinney Rd NE TRLR 23
Lacey, WA 98506-2603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT.PT.61671859WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Physical Therapy & Industrial Rehabilitation, Inc. Physical Therapist PastSince May 25, 2025 Accepting new patients

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": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1164214342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SLEATER KINNEY RD NE TRLR 23",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985062603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 TALLON LN NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985166608",
            "telephone_number": "360-456-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUFRACIO",
        "first_name": "EDDIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT.PT.61671859",
            "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 May 22, 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.