| Olympia Mental Health And Psychiatry Pllc | |
|
4405 7th Ave Se, Ste 200 - Bmp 1133 Lacey WA 98503-9850 | |
| (360) 447-8477 | |
| (360) 783-4475 |
| Full Name | Olympia Mental Health And Psychiatry Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4405 7th Ave Se, Ste 200 - Bmp 1133, Lacey, Washington |
| Authorized Official Name and Position | Shanti Herzog (OWNER) |
| Authorized Official Contact | 3604478477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olympia Mental Health And Psychiatry Pllc 4405 7th Ave Se, Ste 200 - Bmp 1133 Lacey WA 98503-1055 Ph: (360) 447-8477 | Olympia Mental Health And Psychiatry Pllc 4405 7th Ave Se, Ste 200 - Bmp 1133 Lacey WA 98503-9850 Ph: (360) 447-8477 |
| NPI Number | 1164198628 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 11/30/2024 |
| Certification Date | 11/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164198628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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