Provider Demographics
NPI:1770231987
Name:GADOMSKIY, OLGA (LM)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:GADOMSKIY
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 PALMYRA DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-0012
Mailing Address - Country:US
Mailing Address - Phone:509-302-7233
Mailing Address - Fax:
Practice Address - Street 1:1201 JADWIN AVE STE 204
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3431
Practice Address - Country:US
Practice Address - Phone:509-416-5117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW61238768176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife