Provider Demographics
NPI:1467995100
Name:OLYMPIC INTEGRATED BODYWORK, PLLC
Entity Type:Organization
Organization Name:OLYMPIC INTEGRATED BODYWORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:360-643-3366
Mailing Address - Street 1:227 W PATISON ST
Mailing Address - Street 2:
Mailing Address - City:PORT HADLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98339-9751
Mailing Address - Country:US
Mailing Address - Phone:360-643-3366
Mailing Address - Fax:
Practice Address - Street 1:227 W PATISON ST
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-9751
Practice Address - Country:US
Practice Address - Phone:360-643-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty