Provider Demographics
NPI:1790365401
Name:BLANCO-SILVA, OLIVIA C
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:C
Last Name:BLANCO-SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 196TH ST SW
Mailing Address - Street 2:APT 204
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036
Mailing Address - Country:US
Mailing Address - Phone:206-251-2342
Mailing Address - Fax:
Practice Address - Street 1:7326 196TH ST SW
Practice Address - Street 2:APT 204
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036
Practice Address - Country:US
Practice Address - Phone:206-251-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC12355171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter