Provider Demographics
NPI:1295198885
Name:OLMA, DEANNA (OD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:OLMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10104 SW WASHINGTON SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-4457
Mailing Address - Country:US
Mailing Address - Phone:503-968-5249
Mailing Address - Fax:
Practice Address - Street 1:10104 SW WASHINGTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-4457
Practice Address - Country:US
Practice Address - Phone:503-968-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4288ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist