Provider Demographics
NPI:1598152696
Name:OLYMPIC AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:OLYMPIC AREA AGENCY ON AGING
Other - Org Name:O3A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-379-5064
Mailing Address - Street 1:11700 RHODY DR
Mailing Address - Street 2:
Mailing Address - City:PORT HADLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98339-9773
Mailing Address - Country:US
Mailing Address - Phone:360-379-5064
Mailing Address - Fax:360-379-5074
Practice Address - Street 1:11700 RHODY DR
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-9773
Practice Address - Country:US
Practice Address - Phone:360-379-5064
Practice Address - Fax:360-379-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management