Active NPI
Jessica Olivarez
- Physical Therapist
- Tacoma, WA
National Provider Identifier
1982054789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT4205
- Practice address
- Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-4158 - Phone
- (253) 968-0758
- NPI assigned
- Jun 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT4205 | HI | Primary |
Addresses
Primary practice location
Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-4158
Mailing address
95-720 Lanikuhana Ave
Ste 140
Mililani, HI 96789-2985
Phone (808) 623-6244
Other practice location 1
2400 S Avenue A
Yuma, AZ 85364-7127
Phone (928) 344-2000
Other practice location 2
2555 Jimmy Johnson Blvd
Port Arthur, TX 77640-2007
Phone (409) 724-7389
Other practice location 3
95-720 Lanikuhana Ave
Ste 140
Mililani, HI 96789-2985
Phone (808) 623-6244
Other practice location 4
269 S Candy Ln
Cottonwood, AZ 86326-4158
Phone (928) 639-6383
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT4205 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1982054789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-720 LANIKUHANA AVE",
"address_2": "STE 140",
"city": "MILILANI",
"state": "HI",
"postal_code": "967892985",
"telephone_number": "808-623-6244",
"fax_number": "808-623-6414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984314158",
"telephone_number": "253-968-0758"
}
],
"practiceLocations": [
{
"address_1": "2400 S Avenue A",
"address_purpose": "LOCATION",
"city": "Yuma",
"state": "AZ",
"postal_code": "853647127",
"country_code": "US",
"telephone_number": "928-344-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2555 Jimmy Johnson Blvd",
"address_purpose": "LOCATION",
"city": "Port Arthur",
"state": "TX",
"postal_code": "776402007",
"country_code": "US",
"telephone_number": "409-724-7389",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "95-720 Lanikuhana Ave",
"address_2": "Ste 140",
"address_purpose": "LOCATION",
"city": "Mililani",
"state": "HI",
"postal_code": "967892985",
"country_code": "US",
"telephone_number": "808-623-6244",
"fax_number": "808-623-6414",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "269 S Candy Ln",
"address_purpose": "LOCATION",
"city": "Cottonwood",
"state": "AZ",
"postal_code": "863264158",
"country_code": "US",
"telephone_number": "928-639-6383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLIVAREZ",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-13",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT4205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.