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General NPI Number Information
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NPI Number | 1841107497
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Entity Type | Individual
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Provider Name | OLENA PAVLENKO
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Gender | Female
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 6004 CAPITOL BLVD SE
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City | TUMWATER
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State | WA
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Zip | 98501-8520
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Country | US
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Telephone | 360-522-9070
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 SEQUALITCHEW DR UNIT 104
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City | DUPONT
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State | WA
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Zip | 98327-6821
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Country | US
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Telephone | 718-501-2224
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DEHY.DH.70150888
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License Number State | WA
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