Healthcare Provider Details

I. General information

NPI: 1972845733
Provider Name (Legal Business Name): OLYMPIA ORTHOPAEDIC ASSOCIATES PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 LILLY RD NE SUITE 240
OLYMPIA WA
98506-5117
US

IV. Provider business mailing address

PO BOX 368
OLYMPIA WA
98507-0368
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-3850
  • Fax: 360-359-4726
Mailing address:
  • Phone: 360-455-5144
  • Fax: 360-491-7536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number601617151
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number601617151
License Number StateWA

VIII. Authorized Official

Name: DR. PATRICK J HALPIN
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 360-455-5144