Provider Demographics
NPI:1295197309
Name:SCHENCK, OLIVIA LEIGH-QUACH (MD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:LEIGH-QUACH
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 WHITTIER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6711 WHITTIER AVE STE 101
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4540
Practice Address - Country:US
Practice Address - Phone:703-992-9211
Practice Address - Fax:833-550-1728
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101269058207N00000X
IL125.068507207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology