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Individual

SEMRA OLGAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
218991
NY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
MD00046810
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4364OL
BLUE SHIELD #
WA
05
8469736
WA
01
P00393463
RAILROAD MC #
WA
01
US7434599
AETNA PCP PIN
WA
Enumeration date
01/18/2006
Last updated
04/14/2015
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