Organization
OLYMPIC OPTICAL, INC., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE TAYLOR (PRACTICE MANAGER)
(360) 301-4553
Entity
Organization
Contact information
Practice address
1110 W WASHINGTON ST, SEQUIM, WA 98382-3270
(360) 683-1590
(360) 683-7958
Mailing address
PO BOX 849, QUILCENE, WA 98376-0849
(360) 301-4553
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OD00001715
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007880
—
WA
05
—
2020469
—
WA
01
—
6010488
REGENCE BLUE SHIELD
WA
01
—
7905458
AETNA
WA
01
—
P00096244
RAILROAD MEDICARE
WA
01
—
WA0751
NORTHWEST BENEFIT NETWORK
WA
Enumeration date
01/26/2007
Last updated
02/15/2023
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