# OLYMPIA NEUROLOGY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OLYMPIA NEUROLOGY, PLLC
- **Other names:** Brain & Spine Imaging Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891946257
- **Legal business name:** OLYMPIA NEUROLOGY, PLLC
- **Authorized official:** DR. LEO W KESTING MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (360) 464-6030

## Contact information

- **Practice address:** 128 LILLY RD NE, SUITE 101, OLYMPIA, WA 98506-7400
- **Practice address phone:** (360) 464-6030
- **Practice address fax:** (360) 464-6000
- **Mailing address:** PO BOX 960, CENTRALIA, WA 98531-0960
- **Mailing address phone:** (360) 464-6030
- **Mailing address fax:** (360) 464-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | 602098189 | WA | Yes |

## Other

- **Enumeration date:** 10/03/2008
- **Last updated:** 05/07/2009