Individual
EMILY JEAN OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 814-6113
(360) 814-6111
Mailing address
1400 E KINCAID STREET, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60868442
WA
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA60868442
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2112649
—
WA
Enumeration date
09/14/2018
Last updated
05/25/2023
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