NPIMap

Organization Active NPI

Olympic Pain Solutions

  • Nurse Practitioner
  • Mountlake Terrace, WA
National Provider Identifier
1730784497
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
OLYMPIC PAIN SOLUTIONS
Practice address
6603 220TH St SW Ste 102
Mountlake Terrace, WA 98043-2186
Phone
(425) 774-2411
Fax
(425) 672-7065
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Dr. Mark S Shelley, DC, DACNBNPI 1124105275
Title
Owner
Phone
(425) 774-2411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

6603 220TH St SW Ste 102
Mountlake Terrace, WA 98043-2186

Mailing address

6603 220TH St SW Ste 102
Mountlake Terrace, WA 98043-2186
Phone (425) 774-2411

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1730784497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW STE 102",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-774-2411",
            "fax_number": "425-672-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW STE 102",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-774-2411",
            "fax_number": "425-672-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC PAIN SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-774-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, DACNB"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.