Olympic Peninsula Kidney Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

OLYMPIC PENINSULA KIDNEY CENTER

Practice address

450 S Kitsap Blvd
Suite 178
Port Orchard, WA 98366-3773

Phone

(360) 895-7795

Fax

(360) 895-7835

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Katrina Ardel Russell, RN, CNN

Title

Administrator

Phone

(206) 915-9502

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olympic Peninsula Kidney Center South Doing business as

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1386694099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD",
            "address_2": "SUITE 178",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663773",
            "telephone_number": "360-895-7795",
            "fax_number": "360-895-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD",
            "address_2": "SUITE 178",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663773",
            "telephone_number": "360-895-7795",
            "fax_number": "360-895-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC PENINSULA KIDNEY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "ARDEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-915-9502",
        "authorized_official_credential": "RN, CNN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3999109",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympic Peninsula Kidney Center South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anastasia S Oleinikov, LMP
• Deborah Christine Olin, CDPT
• Melissa Olsen
• Patrick D Olsen, ATC
• Olympic Peaks Optical
• Olympic Surgical Associates
• Laurie Ann Oneill, M.D.
• Taylor Orcutt
• Olga Osborn, LMP
• Sheila May Osera

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.