Mark Thoreau Olin, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH61462281 Issued in WA

Practice address

1225 Dexter Ave N
Seattle, WA 98109-3518

Phone

(206) 497-4962

Fax

(206) 316-8655

NPI assigned

Aug 9, 2023

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dr Justin J Favreau PLLC

  dba Stability Spine & Wellness

  • Chiropractor
  • Seattle, WA
  • NPI 1386920171
  NPD
• Vital Roots Prof Corp

  • Primary Care Clinic/Center
  • Seattle, WA
  • NPI 1366880767
  NPD (past)

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1780367417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 5TH AVE N APT 206",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981096014",
            "telephone_number": "510-904-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 DEXTER AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981093518",
            "telephone_number": "206-497-4962",
            "fax_number": "206-316-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIN",
        "first_name": "MARK",
        "middle_name": "THOREAU",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH61462281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Alaina Olfers
• Semra Olgac, MD
• Sarah Oliason
• Erica Lucero Olin, RD
• Jocelin Eulalia Olin, ARNP, DNP
• Brynn Olinger, ND
• Lynne M Oliphant, RN
• Blake A Oliva
• Hernando Pinilla Olivar
• Stephen J. Olivar, MD

• Rehabilitation Chiropractor in Seattle, WA
• Providers in Seattle, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.