Healthcare Provider Details

I. General information

NPI: 1093158123
Provider Name (Legal Business Name): OLGA VALIEVA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: OLGA VALIEVA BISHOP

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E MAIN ST STE 100
AUBURN WA
98002-4905
US

IV. Provider business mailing address

1 E MAIN ST STE 100
AUBURN WA
98002-4905
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-3480
  • Fax: 425-690-9480
Mailing address:
  • Phone: 425-690-3480
  • Fax: 425-690-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number63145-21
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOP60743767
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: