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NPI Code Detail

MEDICARE: OLYMPIC OPTICAL, INC., P.S.

MEDICARE: OLYMPIC OPTICAL, INC., P.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear SupplierOD00001715WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6P00096244OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17905458OTHERWAAETNA
2WA0751OTHERWANORTHWEST BENEFIT NETWORK
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
56010488OTHERWAREGENCE BLUE SHIELD

General Provider Information

NPI Number : 1326194978
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLYMPIC OPTICAL, INC., P.S.
Provider Business Mailing Address
First Line : PO BOX 849
Second Line :
City : QUILCENE
State : WA
Zip : 98376-0849
Country : US
Telephone Number : 360-301-4553
Fax Number :
Provider Business Practice Location Address
First Line : 1110 W WASHINGTON ST
Second Line :
City : SEQUIM
State : WA
Zip : 98382-3270
Country : US
Telephone Number : 360-683-1590
Fax Number : 360-683-7958
Authorized Official
Title or Position : PRACTICE MANAGER
Name : ANGIE TAYLOR
Credential :
Telephone Number : 360-301-4553
Provider Enumeration Date : 01/26/2007
Last Update Date : 02/15/2023

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Directions to “OLYMPIC OPTICAL, INC., P.S. ” Practice Location

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