Provider Demographics
NPI:1720319825
Name:OLEYTE, TIFFINEY (APRN-RX)
Entity Type:Individual
Prefix:
First Name:TIFFINEY
Middle Name:
Last Name:OLEYTE
Suffix:
Gender:F
Credentials:APRN-RX
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 SE HAWTHORNE BLVD # 225
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5246
Mailing Address - Country:US
Mailing Address - Phone:808-225-0264
Mailing Address - Fax:
Practice Address - Street 1:1700 NE 102ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-3804
Practice Address - Country:US
Practice Address - Phone:971-229-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1139363LF0000X
OR201250075NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily