Healthcare Provider Details

I. General information

NPI: 1730804279
Provider Name (Legal Business Name): GRACE ANN OLNEY HCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4743 GALLUP CT SE
OLYMPIA WA
98513-9209
US

IV. Provider business mailing address

4743 GALLUP CT SE
OLYMPIA WA
98513-9209
US

V. Phone/Fax

Practice location:
  • Phone: 360-481-9299
  • Fax:
Mailing address:
  • Phone: 360-481-9299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: