| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1255366910 | KOSHI | LISA | R | 410 PROVIDENCE LN NE | OLYMPIA | WA | 985066927 | |
| 1720343684 | NIMON | LAURA | 410 PROVIDENCE LN NE | OLYMPIA | WA | 985066927 | ||
| 1134476575 | SCHNELL | KENNETH | EUGENE | 410 PROVIDENCE LN NE | OLYMPIA | WA | 985066927 |