Damola Bolutife Olawuyi, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

ML61436016 Issued in WA

Practice address

835 SE Bishop Blvd
Pullman, WA 99163-5512

Phone

(509) 332-2541

NPI assigned

Apr 18, 2023

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Public Hospital District #1-a of Whitman County

  dba Pullman Regional Hospital

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Medicare reassignment NPD
• Public Hospital District #1-a of Whitman County

  dba Pullman Regional Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Pullman, WA
  • NPI 1750401006
  NPD (past)

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1669169991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD STE 401",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-336-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SE BISHOP BLVD",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635512",
            "telephone_number": "509-332-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAWUYI",
        "first_name": "DAMOLA",
        "middle_name": "BOLUTIFE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "ML61436016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Pharmacy Services Inc (Sid's Pharmacy)
• Danielle E Nowlin, LMP
• John Odumah
• Brian Scott Oelke
• Kathleen Mary Ojeda, ND, LM, CPM
• Zachary Orem
• David Osborne, ATC, LMP
• Michael Joseph Osterholt, MD
• Carol A Owings, RN
• Palouse ENT, LLC

• Student in an Organized Health Care Education/Training Program in Pullman, WA
• Providers in Pullman, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.