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General NPI Number Information
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NPI Number | 1700599180
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Entity Type | Individual
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Provider Name | CALALISA OLIVIER LPN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 1700 AIRPORT WAY S
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City | SEATTLE
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State | WA
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Zip | 98134-1618
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Country | US
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Telephone | 206-971-8830
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Fax |
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Provider Business Mailing Address
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Address Line | 3007 MORRIS AVE S
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City | RENTON
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State | WA
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Zip | 98055-5062
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Country | US
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Telephone | 561-306-7488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 61372398
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License Number State | WA
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