| Ccsww-fps Olympia | |
|
402 Yauger Way Sw Olympia WA 98502-8660 | |
| (360) 878-8248 | |
| Not Available |
| Full Name | Ccsww-fps Olympia |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 402 Yauger Way Sw, Olympia, Washington |
| Authorized Official Name and Position | Stephanie Marguerite Thelen (SYSTEM IMPLEMENTATION SPECIALIST) |
| Authorized Official Contact | 2537599544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccsww-fps Olympia 1202 Black Lake Blvd Sw Ste B Olympia WA 98502-7208 Ph: (360) 878-8248 | Ccsww-fps Olympia 402 Yauger Way Sw Olympia WA 98502-8660 Ph: (360) 878-8248 |
| NPI Number | 1568785293 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568785293 | NPI | - | NPPES |
| 169 | Other | WA | COMMUNITY MENTAL HEALTH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 169 (Washington) | Primary |
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