Provider Demographics
NPI:1255153540
Name:DELL, OLIVIA FLORENCE (LMT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:FLORENCE
Last Name:DELL
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 1:695 NW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3401
Mailing Address - Country:US
Mailing Address - Phone:541-633-5093
Mailing Address - Fax:
Practice Address - Street 1:550 NW 3RD AVE STE E
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3546
Practice Address - Country:US
Practice Address - Phone:541-633-5093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLMT-15841225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist