NPIMap

Organization Active NPI

Puget Sound Gastroenterology, PLLC

  • Gastroenterology Physician
  • Olympia, WA
National Provider Identifier
1386340164
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
PUGET SOUND GASTROENTEROLOGY, PLLC
Practice address
209 Lilly Rd NE Ste B
Olympia, WA 98506-5030
Phone
(360) 413-8250
NPI assigned
Feb 3, 2023
Last updated
May 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Alan Oliver, CEO
Title
Ceo
Phone
(786) 530-3820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

209 Lilly Rd NE Ste B
Olympia, WA 98506-5030

Mailing address

209 Lilly Rd NE Ste B
Olympia, WA 98506-5030
Phone (360) 413-8250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000478 WA Part B Supplier - Clinic/Group Practice 1759278252 Receives reassigned benefits from 95 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edmonds, WA; Seattle, WA; Olympia, WA; Mill Creek, WA; Lynnwood, WA; Kirkland, WA; Kennewick, WA; Everett, WA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

7114 W Hood Pl
#433
Kennewick, WA 99336
Phone (509) 734-4885

13030 121st Way NE
Ste 100
Kirkland, WA 98034
Phone (206) 899-4500

19000 33rd Ave W
Ste 200
Lynnwood, WA 98036
Phone (425) 686-7138

19000 33rd Ave W
Ste 230
Lynnwood, WA 98036
Phone (425) 686-7138

16504 9th Ave SE
Ste 201
Mill Creek, WA 98012
Phone (425) 686-7138

209 Lilly Rd NE
Ste B
Olympia, WA 98506
Phone (360) 413-8250

801 Broadway
Ste 725
Seattle, WA 98122
Phone (206) 215-3168

Practitioners & affiliated clinicians

Practitioners 90

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.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1386340164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065030",
            "telephone_number": "360-413-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065030",
            "telephone_number": "360-413-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-530-3820",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "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 May 16, 2025; 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.