PSYCHIATRIC SERVICES OF OLYMPIA PLLC (NPI# 1760811475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760811475 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC SERVICES OF OLYMPIA PLLC |
| Practice Address |
2114 Caton Way Sw 201 Olympia WA 98502-1177 |
| Mailing Address |
123 18th Ave Se Olympia WA 98501-2211 |
| Practice Telephone | 3607093332 |
| Practice Fax Number | 3607093336 |
| Mailing Telephone | 3607093332 |
| Mailing Fax Number | 3607093336 |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |
| Authorized Official Name | MS. LINDAA SUE KELLAMS-KEITH (OWNER) |
| Authorized Official Telephone | 3607093332 |
| Authorized Official Credential | A.R.N.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP30004049 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2114 CATON WAY SW 201 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-1177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801353719 | Boyd Cowan, LLC | Nurse Practitioner | 209 4th Ave E Ste 214, Olympia, WA 98501-6969 | 2019-02-27 |
| 1336441765 | Laura Wagner | Nurse Practitioner | 1700 Cooper Point Road Sw, Ste C-4, Olympia, WA 98502 | 2010-11-17 |
| 1992886956 | Jennifer Ann Clingenpeel | Nurse Practitioner | 200 Lilly Rd Ne Ste C, Olympia, WA 98506-5080 | 2006-10-18 |
| 1316574056 | Tausha Mccarthy | Nurse Practitioner | 908 5th Ave Se, Olympia, WA 98501-1507 | 2020-03-24 |
| 1669016093 | Tracie Ross | Nurse Practitioner | 908 5th Ave Se, Olympia, WA 98501-1507 | 2019-10-29 |
| 1952958803 | Genuine Healthcare, Pllc | Nurse Practitioner | 1800 Cooper Point Rd Sw Ste 19, Olympia, WA 98502-1179 | 2019-08-23 |
| 1578039749 | Melissa Jo Gallardo | Nurse Practitioner | 225 State Ave Ne, Olympia, WA 98501-6951 | 2018-10-15 |
| 1952897373 | West Olympia Psychiatry Pllc | Nurse Practitioner | 924 7th Ave Se, Olympia, WA 98501-1548 | 2018-07-09 |
| 1124400783 | Diana Liebner | Nurse Practitioner | 3857 Martin Way E, Olympia, WA 98506-5268 | 2015-06-19 |
| 1700267374 | Amy Lorraine Heckler | Nurse Practitioner | 3030 Limited Ln Nw, Olympia, WA 98502-2704 | 2015-06-09 |
| Find all providers in OLYMPIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.