| Olympia Mental Health And Psychiatry Pllc | |
|
1314 Garrison St Ne Olympia WA 98506-4337 | |
| (360) 504-6110 | |
| Not Available |
| Full Name | Olympia Mental Health And Psychiatry Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1314 Garrison St Ne, Olympia, Washington |
| Authorized Official Name and Position | Shanti Herzog (OWNER) |
| Authorized Official Contact | 3605848270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olympia Mental Health And Psychiatry Pllc 2103 Harrison Ave Nw Ste #2-#880 Olympia WA 98502-2607 Ph: (360) 504-6110 | Olympia Mental Health And Psychiatry Pllc 1314 Garrison St Ne Olympia WA 98506-4337 Ph: (360) 504-6110 |
| NPI Number | 1164198628 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 10/05/2021 |
| Certification Date | 08/18/2021 |
| 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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