Provider Demographics
NPI:1891228813
Name:ALMINIANA, OLIVIA LINSEY (LMT)
Entity Type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:LINSEY
Last Name:ALMINIANA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 NE TILLAMOOK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3749
Mailing Address - Country:US
Mailing Address - Phone:213-434-8407
Mailing Address - Fax:
Practice Address - Street 1:833 SE MAIN ST
Practice Address - Street 2:#308
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3454
Practice Address - Country:US
Practice Address - Phone:213-434-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21425225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist