Provider Demographics
NPI:1568585693
Name:OLYMPIC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:OLYMPIC SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-895-0588
Mailing Address - Street 1:450 S KITSAP BLVD
Mailing Address - Street 2:STE. 2220
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3773
Mailing Address - Country:US
Mailing Address - Phone:360-895-0588
Mailing Address - Fax:360-895-9343
Practice Address - Street 1:450 S KITSAP BLVD
Practice Address - Street 2:STE. 2220
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3773
Practice Address - Country:US
Practice Address - Phone:360-895-0588
Practice Address - Fax:360-895-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006085163W00000X
WADE00009045261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Not Answered261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery