Etherton, Inc

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

ETHERTON, INC

Doing business as

Olympia Integrative Medicine

Practice address

2610 Yelm Hwy SE
Olympia, WA 98501-4826

Phone

(360) 870-2011

Fax

(360) 925-3136

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Thomas Etherton, NP-CNPI 1912547365

Title

President

Phone

(360) 915-9389

Specialties & licenses 1

Addresses

Other names 1

• Olympia Integrative Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Thomas Lee Etherton, NP-C

  • Primary Care Nurse Practitioner
  • Olympia, WA
  • NPI 1912547365

  Single Specialty

  Medicare reassignment NPD Authorized official
• Melissa Bronoske, PA-C

  • Physician Assistant
  • Eatonville, WA
  • NPI 1477982700
  NPD (past)
• Tanya Nan Young Jackins

  • Family Nurse Practitioner
  • Chehalis, WA
  • NPI 1659192417
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1518599273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 YELM HWY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-915-9389",
            "fax_number": "360-925-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 YELM HWY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-870-2011",
            "fax_number": "360-925-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHERTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "ETHERTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-915-9389",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympia Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Olympia Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Curtis Eschels, L.AC.
• Jacquelin Escoto Benitez, OD
• Jamie Dawnell Espinoza
• Amanda L Essert, ARNP-FNP
• Kyle Estrella
• Thomas Lee Etherton, NP-C
• Teresa Eucker, LMT
• Eugen Sine Enterprises Inc
• Eugene H. Peeples, DDS
• Evan H. Hirsch, M.D., Inc., P.S. (Hirsch Holistic Family Medicine)

• Adult Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Adult Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.