Organization
VOLUNTEERS IN MEDICINE OF THE OLYMPICS
Active
Other names
Volunteers in Medicine of the Olympics Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E HOGAN CMA (EXECUTIVE DIRECTOR)
(360) 457-4431
Entity
Organization
Contact information
Practice address
819 GEORGIANA ST, PORT ANGELES, WA 98362-3511
(360) 457-4431
(360) 457-7755
Mailing address
PO BOX 639, PORT ANGELES, WA 98362-0114
(360) 457-4431
(360) 457-7755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
602166835
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031476
—
WA
Enumeration date
01/12/2017
Last updated
01/12/2017
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