Healthcare Provider Details

I. General information

NPI: 1417064643
Provider Name (Legal Business Name): OLYMPIC CLINICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST MAILSTOP E170
SEATTLE WA
98133-8401
US

IV. Provider business mailing address

18820 AURORA AVE N SUITE 104B
SHORELINE WA
98133-3900
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-1244
  • Fax: 206-368-1270
Mailing address:
  • Phone: 206-542-7118
  • Fax: 206-542-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30001778
License Number StateWA

VIII. Authorized Official

Name: CYNTHIA ANN DOWNS
Title or Position: PRESIDENT
Credential: A.R.N.P.
Phone: 425-275-7629