Individual provider Active NPI

Eric Wayne Basiliere, ND

  • Naturopath
  • Lacey, WA
National Provider Identifier
1598270258
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT60812682 Issued in WA
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
NT60812682OtherWANATUROPATHIC 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

LicenseStateTypeSpecialty
NT60812682WAMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.