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Individual

OLYMPIA TABITA HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7301 MISSISSIPPI DR, VANCOUVER, WA 98664
(360) 694-5480
(360) 750-4892
Mailing address
7301 MISSISSIPPI DR, VANCOUVER, WA 98664
(360) 694-5480
(360) 750-4892

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
650700
WA

Other

Enumeration date
03/28/2008
Last updated
03/28/2008
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