Individual
OLIVIA TULLIER FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 NE 87TH AVE STE 301, VANCOUVER, WA 98664-1965
(360) 514-1854
(360) 514-6063
Mailing address
8455 FENTON ST APT 430, SILVER SPRING, MD 20910-5042
(760) 900-4267
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61268379
WA
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2019
Last updated
11/07/2023
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