Active NPI
Eric Wayne Basiliere, ND
- Naturopath
- Lacey, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- NT60812682
- Practice address
- 4520 Intelco Loop SE BLDG 3
Lacey, WA 98503-6008 - Phone
- (360) 489-0429
- Fax
- (360) 972-2526
- NPI assigned
- Dec 4, 2017
- Last updated
- Jun 29, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | NT60812682 | WA | Primary |
Addresses
Primary practice location
4520 Intelco Loop SE BLDG 3
Lacey, WA 98503-6008
Mailing address
4520 Intelco Loop SE BLDG 3
Lacey, WA 98503-6008
Phone (360) 489-0429
Other practice location 1
2772 Arnold St
DuPont, WA 98327-8717
Phone (714) 595-4661
Other practice location 2
2401 Bristol Ct SW Ste A102
Olympia, WA 98502-6037
Phone (360) 350-0539
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NT60812682 | Other | WA | NATUROPATHIC PHYSICIAN LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NT60812682 | WA | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Basiliere & Crockett | Current | Accepting new patients | |
| Dream Enterprises, Inc | Past | Accepting new patients | |
| Absolute Health Clinic | Past | Accepting new patients |
Locations
4520 Intelco Loop SE
Bldg 3
Lacey, WA 98503
Phone (360) 388-0485
Interoperability endpoints
- eric.basiliere.1@28626.direct.athenahealth.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Health Maintenance Organization
- Olympia, WA
- NPI 1376988394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1598270258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 INTELCO LOOP SE BLDG 3",
"city": "LACEY",
"state": "WA",
"postal_code": "985036008",
"telephone_number": "360-489-0429",
"fax_number": "360-972-2526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 INTELCO LOOP SE BLDG 3",
"city": "LACEY",
"state": "WA",
"postal_code": "985036008",
"telephone_number": "360-489-0429",
"fax_number": "360-972-2526"
}
],
"practiceLocations": [
{
"address_1": "2772 Arnold St",
"address_purpose": "LOCATION",
"city": "DuPont",
"state": "WA",
"postal_code": "983278717",
"country_code": "US",
"telephone_number": "714-595-4661",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2401 Bristol Ct SW Ste A102",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985026037",
"country_code": "US",
"telephone_number": "360-350-0539",
"fax_number": "360-539-7336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASILIERE",
"first_name": "ERIC",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-04",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "WA",
"license": "NT60812682",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATUROPATHIC PHYSICIAN LICENSE",
"identifier": "NT60812682",
"state": "WA"
}
],
"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 Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.