Provider Demographics
NPI:1508653536
Name:PESKOVA, OLGA (MS, PHD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:PESKOVA
Suffix:
Gender:
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 1ST AVE UNIT 1208
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-3523
Mailing Address - Country:US
Mailing Address - Phone:469-500-3112
Mailing Address - Fax:
Practice Address - Street 1:2721 1ST AVE UNIT 1208
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-3523
Practice Address - Country:US
Practice Address - Phone:469-500-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA235Z00000X
GASLP013539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist