Provider Demographics
NPI:1669873626
Name:KAREN FEELEY D C
Entity type:Organization
Organization Name:KAREN FEELEY D C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-561-4238
Mailing Address - Street 1:4525 RIDGEWOOD CT NW
Mailing Address - Street 2:B
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-3642
Mailing Address - Country:US
Mailing Address - Phone:360-561-4238
Mailing Address - Fax:
Practice Address - Street 1:1910 BLACK LAKE BLVD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-5651
Practice Address - Country:US
Practice Address - Phone:360-561-4238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60217866261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service