Provider Demographics
NPI:1154600757
Name:OLYMPIA THERAPY LLC
Entity type:Organization
Organization Name:OLYMPIA THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARY
Authorized Official - Middle Name:HEATHER
Authorized Official - Last Name:MCADAMS HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:360-357-2370
Mailing Address - Street 1:1610 BISHOP RD SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7303
Mailing Address - Country:US
Mailing Address - Phone:360-357-2370
Mailing Address - Fax:360-357-2374
Practice Address - Street 1:1610 BISHOP RD SW
Practice Address - Street 2:SUITE 105
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7303
Practice Address - Country:US
Practice Address - Phone:360-357-2370
Practice Address - Fax:360-357-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty