Provider Demographics
NPI:1497497366
Name:RIVAS, OLIVIA (RN, BSN, CCM)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:RN, BSN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14890 SW DAPHNE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-5163
Mailing Address - Country:US
Mailing Address - Phone:503-523-8700
Mailing Address - Fax:
Practice Address - Street 1:14890 SW DAPHNE CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-5163
Practice Address - Country:US
Practice Address - Phone:503-523-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00172719163WC0400X
OR200741516RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management