Provider Demographics
NPI:1952958803
Name:GENUINE HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:GENUINE HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-972-0290
Mailing Address - Street 1:2323 KERRYSDALE DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-3493
Mailing Address - Country:US
Mailing Address - Phone:360-972-0290
Mailing Address - Fax:360-763-5701
Practice Address - Street 1:1800 COOPER POINT RD SW STE 19
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1179
Practice Address - Country:US
Practice Address - Phone:564-999-4544
Practice Address - Fax:360-763-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHALLHW345KGOtherDRIVERS LICENSE