Organization
OLYMPIC DERMATOLOGY & LASER CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LENNAE HOLM (PRACTICE ADMINISTRATOR)
(360) 459-1700
Entity
Organization
Contact information
Practice address
424 LILLY RD NE, OLYMPIA, WA 98506-5132
(360) 459-1700
(360) 459-0537
Mailing address
424 LILLY RD NE, OLYMPIA, WA 98506-5132
(360) 459-1700
(360) 459-0537
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60046050
WA
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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