Organization
OLYMPIA MENTAL HEALTH AND PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTI HERZOG ARNP (OWNER)
(360) 447-8477
Entity
Organization
Contact information
Practice address
4405 7TH AVE SE, STE 200 - BMP 1133, LACEY, WA 98503-9850
(360) 447-8477
(360) 783-4475
Mailing address
4405 7TH AVE SE, STE 200 - BMP 1133, LACEY, WA 98503-1055
(360) 447-8477
(360) 783-4475
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
11/30/2024
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