Individual
OLGA BOLTENKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
134 NE 18TH AVE, CAMAS, WA 98607
(360) 952-2073
Mailing address
134 NE 18TH AVE, CAMAS, WA 98607
(360) 952-2073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP61094253
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
101YM0800X
Mental Health Counselor
—
WA
104100000X
Social Worker
LW61065828
WA
1041C0700X
Clinical Social Worker
13419
OR
Other
Enumeration date
07/01/2014
Last updated
05/02/2024
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