Provider Demographics
NPI:1952897373
Name:WEST OLYMPIA PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:WEST OLYMPIA PSYCHIATRY PLLC
Other - Org Name:MARY SCHROEDER ARNP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-742-4717
Mailing Address - Street 1:802 OVERHULSE RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-2552
Mailing Address - Country:US
Mailing Address - Phone:360-742-4717
Mailing Address - Fax:
Practice Address - Street 1:924 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1548
Practice Address - Country:US
Practice Address - Phone:360-485-0165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60545632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty