Organization
SIDEWALK
Active
Organization
SIDEWALK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP OWEN (EXECUTIVE DIRECTOR)
(360) 915-7306
Entity
Organization
Contact information
Practice address
225 STATE AVE NE, OLYMPIA, WA 98501-6951
(360) 515-5587
Mailing address
1139 5TH AVE SE, OLYMPIA, WA 98501-1601
(360) 915-7306
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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