Olympic Surgical Services, P.L.L.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00032175 Issued in WA

Legal business name

OLYMPIC SURGICAL SERVICES, P.L.L.C.

Practice address

1710 N 13TH Loop Rd
Shelton, WA 98584-2166

Phone

(360) 426-4142

Fax

(360) 427-5772

NPI assigned

Jul 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cheryl R Mahlberg, M.A.

Title

Office/Business Manager

Phone

(360) 426-4142

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1245260454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 N 13TH LOOP RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842166",
            "telephone_number": "360-426-4142",
            "fax_number": "360-427-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N 13TH LOOP RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842166",
            "telephone_number": "360-426-4142",
            "fax_number": "360-427-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC SURGICAL SERVICES, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "MAHLBERG",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE/BUSINESS MANAGER",
        "authorized_official_telephone_number": "360-426-4142",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00032175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7063266",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olympic Physicians P.L.L.C.
• Olympic Physicians P.L.L.C.
• Olympic Physicians P.L.L.C.
• Olympic Physicians P.L.L.C.
• Olympic Physicians, PLLC
• Optical Shop of Wa Inc
• Lora Osborne
• Medina Othman Glenn, PA
• Jack Lynn Ott, RPH
• Jared Preston Outen

• Surgery Physician in Shelton, WA
• Providers in Shelton, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.