NPIMap

Organization Active NPI

Olympic Physicians P.L.L.C.

  • Primary Care Clinic/Center
  • Shelton, WA
National Provider Identifier
1417156183
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OLYMPIC PHYSICIANS P.L.L.C.
Practice address
221 Professional Way
Shelton, WA 98584-4404
Phone
(360) 426-2500
Fax
(360) 426-2787
NPI assigned
Jul 13, 2007
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Ms. Pam Schlauderaff
Title
Clinic Manager
Phone
(360) 426-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

221 Professional Way
Shelton, WA 98584-4404

Mailing address

237 Professional Way
Shelton, WA 98584-4404
Phone (360) 426-2500

Other identifiers 1

IdentifierTypeStateIssuer
7140098MedicaidWA

National Provider Directory

National Provider Directory

Locations

1930 N 13th St
Shelton, WA 98584
Phone (360) 426-2500

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1417156183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500",
            "fax_number": "360-426-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500",
            "fax_number": "360-426-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC PHYSICIANS P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "SCHLAUDERAFF",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "360-426-2500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7140098",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; 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.