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

19472 Powder Hill PL NE
Suite 100
Poulsbo, WA 98370-7473

Phone

(360) 598-9712

Fax

(360) 598-9716

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

C.O.O.

Phone

(206) 915-9502

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Olympic Peninsula Kidney Center North 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": "1303257600000",
    "number": "1548210255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19472 POWDER HILL PL NE",
            "address_2": "SUITE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707473",
            "telephone_number": "360-598-9712",
            "fax_number": "360-598-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19472 POWDER HILL PL NE",
            "address_2": "SUITE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707473",
            "telephone_number": "360-598-9712",
            "fax_number": "360-598-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC PENINSULA KIDNEY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "ARDEL",
        "authorized_official_title_or_position": "C.O.O.",
        "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 North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maryanne O'Connor, LMP
• Shana Rae Oellrich, RDH
• Of the River PLLC
• Scott A Olson, DDS
• Victor Olvera, LMP
• Olympic Radiology LLC
• David JC Omorchoe, MD
• Naomi Whitney Orong, LMT
• Jennifer Osborn, OTA
• Lauren Elizabeth Osborne, MA, LMHC-A, ATR-P

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Poulsbo, WA
• Providers in Poulsbo, 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 Apr 20, 2011; 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.