Healthcare Provider Details

I. General information

NPI: 1285540112
Provider Name (Legal Business Name): OLIVIA DENTON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22802 MERIDIAN E
GRAHAM WA
98338-9145
US

IV. Provider business mailing address

5704 23RD ST E APT C1
FIFE WA
98424-4506
US

V. Phone/Fax

Practice location:
  • Phone: 253-375-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70164924
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: