Provider Demographics
NPI:1013734433
Name:DACK, OLIVIA JANE (ND)
Entity type:Individual
Prefix:MISS
First Name:OLIVIA
Middle Name:JANE
Last Name:DACK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10235 62ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2304
Mailing Address - Country:US
Mailing Address - Phone:206-631-9162
Mailing Address - Fax:
Practice Address - Street 1:10235 62ND AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-2304
Practice Address - Country:US
Practice Address - Phone:206-631-9162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath