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General NPI Number Information
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NPI Number | 1356210892
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Entity Type | Organization
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Legal Business Name | OLYMPIC PENINSULA COMMUNITY CLINIC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 819 GEORGIANA ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3511
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Country | US
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Telephone | 360-457-4431
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Fax | 360-457-7755
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Provider Business Mailing Address
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Address Line | 819 GEORGIANA ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3511
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Country | US
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Telephone | 360-457-4431
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | T SCOTT BRANDON
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Credential |
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Telephone | 360-457-4431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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