Puget Sound Healthcare - Olympia LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PUGET SOUND HEALTHCARE - OLYMPIA LLC

Doing business as

Puget Sound Healthcare Center

Practice address

4001 Capitol Mall Dr SW
Olympia, WA 98502-8657

Phone

(360) 754-9792

Fax

(360) 754-2455

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dov E. Jacobs

Title

Manager

Phone

(323) 678-4426

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Puget Sound Healthcare Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen Bemiller, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Olympia, WA
  • NPI 1063617884
  NPD (past)
• Julie Christine Colaw, PT

  • Physical Therapist
  • Olympia, WA
  • NPI 1114123551
  NPD (past)
• Keith Evans

  • Physical Therapy Assistant
  • Olympia, WA
  • NPI 1982804084
  NPD (past)
• Cheryl Klikas

  • Occupational Therapy Assistant
  • Olympia, WA
  • NPI 1376741470
  NPD (past)
• Caitlin Kim Dean, OTR/L

  • Occupational Therapist
  • Missoula, MT
  • NPI 1962795096
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1629142294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 CAPITOL MALL DRIVE SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028657",
            "telephone_number": "360-754-9792",
            "fax_number": "360-754-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 CAPITOL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028657",
            "telephone_number": "360-754-9792",
            "fax_number": "360-754-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND HEALTHCARE - OLYMPIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "DOV",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "323-678-4426",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110102",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puget Sound Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Psychiatric and Counseling Services of Olympia, PS
• Psychiatric Services of Olympia PLLC
• Public Hospital District No 1 of Mason County (Olympia Ankle and Foot)
• Puget Sound Care LLC (Puget Sound Care)
• Puget Sound Gastroenterology, PLLC
• Puget Sound Healthcare-Olympia, LLC (Puget Sound Healthcare Center)
• Ralph Jay Nadong Pulido, MSN, ARNP, FNP-C
• Lindsey Cheryl Pulley, SLP-A
• Alexandria Nichole Purcell, RDN
• Shawna E Purcell

• Skilled Nursing Facility in Olympia, WA
• Providers in Olympia, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.