Olympic Wellness PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OLYMPIC WELLNESS PLLC

Practice address

4313 6TH Ave SE, Suite C
Attn: Harrison Detroja
Lacey, WA 98503

Phone

(360) 217-9425

Fax

(866) 522-6325

NPI assigned

Aug 24, 2024

Last updated

Apr 13, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harrison Detroja, PMHNP-BCNPI 1154670628

Title

Member

Phone

(360) 217-9425

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Harrison H Detroja, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Longview, WA
  • NPI 1154670628
  NPD (past) Authorized official

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

{
    "created_epoch": "1724457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744502400000",
    "number": "1861225724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 6TH AVE SE STE C",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031072",
            "telephone_number": "360-217-9425",
            "fax_number": "866-522-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 6TH AVE SE, SUITE C",
            "address_2": "ATTN: HARRISON DETROJA",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-217-9425",
            "fax_number": "866-522-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-24",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A",
        "authorized_official_last_name": "DETROJA",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-217-9425",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olympia Smiles Dentistry for All Ages
• Olympic Counseling Group
• Olympic Dental Center, LLC
• Olympic Health and Recovery Services
• Olympic Recovery Center LLC
• Melanie Ondong, DNP, FNP-C
• Seth Opp-Beckman
• Optimistic Mental Healthcare
• John Orchard-Hays, DPT
• Robert Martin Ore, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Lacey, WA
• Providers in Lacey, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2025; 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.