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General NPI Number Information
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NPI Number | 1952897373
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Entity Type | Organization
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Legal Business Name | WEST OLYMPIA PSYCHIATRY PLLC
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 924 7TH AVE SE
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City | OLYMPIA
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State | WA
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Zip | 98501-1548
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Country | US
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Telephone | 360-485-0165
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Fax |
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Provider Business Mailing Address
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Address Line | 802 OVERHULSE RD NW
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City | OLYMPIA
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State | WA
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Zip | 98502-2552
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Country | US
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Telephone | 360-742-4717
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MS. MARY E SCHROEDER
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Credential | ARNP
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Telephone | 360-742-4717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60545632
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License Number State | WA
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