Provider Demographics
NPI:1356541940
Name:OLIVER, ARLENE T (ARNP)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:T
Last Name:OLIVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:413 LILLY RD NE
Mailing Address - Street 2:PSYCHIATRY UNIT
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5133
Mailing Address - Country:US
Mailing Address - Phone:360-493-7191
Mailing Address - Fax:360-493-5756
Practice Address - Street 1:413 LILLY RD NE
Practice Address - Street 2:PSYCHIATRY UNIT
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5133
Practice Address - Country:US
Practice Address - Phone:360-493-7191
Practice Address - Fax:360-493-5756
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30004534207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
S67385Medicare UPIN