Thomas Lee Etherton, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP61034795 Issued in WA

Practice address

2610 Yelm Hwy SE
Olympia, WA 98501-4826

Phone

(360) 915-9389

NPI assigned

Jan 14, 2020

Last updated

Aug 12, 2021By 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: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomas.etherton.1@23980.direct.athenahealth.com

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.

• Etherton, Inc

  dba Olympia Integrative Medicine

  • Adult Medicine Physician
  • Olympia, WA
  • NPI 1518599273

  Single Specialty

  Medicare reassignment NPD Authorized official
• Premier Health, LLC

  dba Capital Men's Clinic

  • Health Service Clinic/Center
  • Olympia, WA
  • NPI 1972197655
  NPD Authorized official

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1912547365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 YELM HWY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-915-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 YELM HWY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-915-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERTON",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2021-08-12",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61034795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelin Escoto Benitez, OD
• Jamie Dawnell Espinoza
• Amanda L Essert, ARNP-FNP
• Kyle Estrella
• Etherton, Inc (Olympia Integrative Medicine)
• Teresa Eucker, LMT
• Eugen Sine Enterprises Inc
• Eugene H. Peeples, DDS
• Evan H. Hirsch, M.D., Inc., P.S. (Hirsch Holistic Family Medicine)
• Andrea Marie Evans

• Primary Care Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Primary Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.