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Organization
VOLUNTEERS IN MEDICINE OF THE OLYMPICS
Active
Organization
VOLUNTEERS IN MEDICINE OF THE OLYMPICS
Active
Other names
Volunteers in Medicine of the Olympics Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E HOGAN CMA (EXECUTIVE DIRECTOR)
(360) 457-4431
Entity
Organization
Contact information
Practice address
819 GEORGIANA ST, PORT ANGELES, WA 98362-3511
(360) 457-4431
(360) 457-7755
Mailing address
PO BOX 639, PORT ANGELES, WA 98362-0114
(360) 457-4431
(360) 457-7755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
602166835
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031476
—
WA
Enumeration date
01/12/2017
Last updated
01/12/2017
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