Provider Demographics
NPI:1043448160
Name:HERNANDEZ, OLGA ELIZABETH (DO)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:ELIZABETH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1020 ANDERSON DR
Mailing Address - Street 2:STE 203
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1055
Mailing Address - Country:US
Mailing Address - Phone:360-533-6063
Mailing Address - Fax:360-533-2204
Practice Address - Street 1:1020 ANDERSON DR
Practice Address - Street 2:SUITE 203
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1055
Practice Address - Country:US
Practice Address - Phone:360-533-6063
Practice Address - Fax:360-533-2204
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2019-02-20
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Provider Licenses
StateLicense IDTaxonomies
WAOL60095268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine