| Organization Name: | OLYMPIC SENIOR CARE, LLC |
| NPI Number: | 1487042552 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS KEMP BOUGHNER (OWNER) |
| Mailing Address: | 675 N 5th Ave Ste 1b Sequim |
| State: | WA US |
| Postal Code: | 983823066 |
| Phone Number: | 3606812511 |
| Fax Number: | 3606810350 |
| NPI Enumeration Date: | 12/24/2014 |
| NPI Last Update Date: | 12/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | IHS.FS.00000147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |