Individual
OLIVIA VENNEBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1147 N FAIRHOPE PL, RIDGEFIELD, WA 98642-5575
(503) 867-3168
Mailing address
1147 N FAIRHOPE PL, RIDGEFIELD, WA 98642-5575
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
10051901
OR
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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