Provider Demographics
NPI:1700506755
Name:OLYMPIC OCCUPATIONAL MEDICINE, LLC
Entity Type:Organization
Organization Name:OLYMPIC OCCUPATIONAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNBO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:731-676-7643
Mailing Address - Street 1:11101 SE SOUTHWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8982
Mailing Address - Country:US
Mailing Address - Phone:731-676-7643
Mailing Address - Fax:
Practice Address - Street 1:4411 POINT FOSDICK DR STE 305
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1703
Practice Address - Country:US
Practice Address - Phone:731-676-7643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1487212783OtherINDIVIDUAL NPI