Active NPI
Olympia Tabita Harris
- Adult Care Home Facility
- Vancouver, WA
National Provider Identifier
1861664971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 650700
- Practice address
- 7301 Mississippi Dr
Vancouver, WA 98664 - Phone
- (360) 694-5480
- Fax
- (360) 750-4892
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 650700 | WA | Primary |
Addresses
Primary practice location
7301 Mississippi Dr
Vancouver, WA 98664
Mailing address
7301 Mississippi Dr
Vancouver, WA 98664
Phone (360) 694-5480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 650700 | WA | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1861664971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 MISSISSIPPI DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98664",
"telephone_number": "360-694-5480",
"fax_number": "360-750-4892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 MISSISSIPPI DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98664",
"telephone_number": "360-694-5480",
"fax_number": "360-750-4892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "OLYMPIA",
"middle_name": "TABITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "WA",
"license": "650700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.