Organization
STANLEY & UTTERBACK
Active
Other names
Olympia Podiatry Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEROD STANLEY (CO OWNER)
(615) 605-9249
Entity
Organization
Contact information
Practice address
3525 ENSIGN RD NE STE N, OLYMPIA, WA 98506-5065
(360) 943-9600
(360) 943-9694
Mailing address
9119 CLASSIC DR NE, LACEY, WA 98516-9247
(216) 469-5758
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 60735213
WA
Other
Enumeration date
05/04/2017
Last updated
01/02/2024
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