Healthcare Provider Details

I. General information

NPI: 1255126744
Provider Name (Legal Business Name): OLIVIA HERSHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 RAINIER AVE S STE 201
SEATTLE WA
98144-4642
US

IV. Provider business mailing address

2200 RAINIER AVE S STE 201
SEATTLE WA
98144-4642
US

V. Phone/Fax

Practice location:
  • Phone: 260-443-2689
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: