# VOLUNTEERS IN MEDICINE OF THE OLYMPICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Volunteers in Medicine of the Olympics Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881130912
- **Authorized official:** MARY E HOGAN CMA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (360) 457-4431

## Contact information

- **Practice address:** 819 GEORGIANA ST, PORT ANGELES, WA 98362-3511
- **Practice address phone:** (360) 457-4431
- **Practice address fax:** (360) 457-7755
- **Mailing address:** PO BOX 639, PORT ANGELES, WA 98362-0114
- **Mailing address phone:** (360) 457-4431
- **Mailing address fax:** (360) 457-7755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 602166835 | WA | Yes |

## Other

- **Enumeration date:** 01/12/2017
- **Last updated:** 01/12/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2031476 | — | WA |