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General NPI Number Information
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NPI Number | 1780318634
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Entity Type | Individual
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Provider Name | LAURA MARIE OLVERA
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Gender | Female
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 320 6TH ST
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City | RAYMOND
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State | WA
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Zip | 98577-2503
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Country | US
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Telephone | 360-280-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 4741 PLOVER ST NE
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City | OLYMPIA
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State | WA
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Zip | 98516-4531
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Country | US
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Telephone | 619-493-7386
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 46-1009805
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License Number State | WA
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