Healthcare Provider Details

I. General information

NPI: 1629666078
Provider Name (Legal Business Name): MOLATO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2020
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1946 4TH AVE E
OLYMPIA WA
98506-4632
US

IV. Provider business mailing address

1946 4TH AVE E
OLYMPIA WA
98506-4632
US

V. Phone/Fax

Practice location:
  • Phone: 360-352-3333
  • Fax:
Mailing address:
  • Phone: 360-352-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT MOLATO
Title or Position: PRESIDENT
Credential: DC
Phone: 910-546-3318