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EAGLE HARBOR HEALTH & CHIROPRACTIC
NPI 1881964419
Chiropractor in Olympia, WA

Active since January 12, 2012
2405 EVERGREEN PARK DR SW STE B1, OLYMPIA, WA 98502(206) 842-2690 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 11, 2025, Sep 30, 2020 (2 updates tracked since 2020).

About Eagle Harbor Health & Chiropractic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAGLE HARBOR HEALTH & CHIROPRACTIC (NPI 1881964419) is a healthcare organization registered as a chiropractor in Olympia, Washington and active in the NPI registry since January 2012. The organization maintains 2 additional practice locations and lists Kirk William Petheram, Owner, as its authorized official.

NPPES Registry Identity

NPI1881964419
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameEAGLE HARBOR HEALTH & CHIROPRACTIC
Location Address2405 EVERGREEN PARK DR SW STE B1Olympia, WA 98502-6000
Mailing Address3212 Red Fern Dr NwOlympia, WA 98502-3224 · (206) 842-2690
Phone(206) 842-2690
Organization SubpartNo
Authorized OfficialKirk William PetheramOwner · (206) 842-2702
Enumeration DateJanuary 12, 2012
Last NPPES UpdateJuly 11, 20252 updates tracked since enumeration
NPPES CertifiedJuly 11, 2025
✔ NPI 1881964419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WA · CH00003554
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
2405 EVERGREEN PARK DR SW STE B1, Olympia, WA 98502
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Secondary Practice Locations 2

Location 1911 Hildebrand Ln NE Ste 102Bainbridge Island, WA 98110-2824 · Phone (120) 684-2269 · Fax (206) 842-2847
Location 2271 Wyatt Way NE Ste 208Bainbridge Island, WA 98110-2873 · Phone (206) 842-2690

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eagle Harbor Health & Chiropractic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Eagle Harbor Health & Chiropractic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kirk Petheram, D.C.
Chiropractic
NPI 1770613580
701 WINSLOW WAY E STE B
Bainbridge Island, WA 98110
(206) 842-2702
45 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eagle Harbor Health & Chiropractic's NPI number?

The NPI number for Eagle Harbor Health & Chiropractic is 1881964419. It was assigned to this organization in the NPPES registry on January 12, 2012.

Where is Eagle Harbor Health & Chiropractic located?

Eagle Harbor Health & Chiropractic is located at 2405 Evergreen Park Dr SW Ste B1, Olympia, WA 98502. The listed phone number is (206) 842-2690.

What is Eagle Harbor Health & Chiropractic's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Eagle Harbor Health & Chiropractic enrolled in Medicare?

Yes. Eagle Harbor Health & Chiropractic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eagle Harbor Health & Chiropractic?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Eagle Harbor Health & Chiropractic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Eagle Harbor Health & Chiropractic accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Eagle Harbor Health & Chiropractic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eagle Harbor Health & Chiropractic was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.