Individual
TIFFANY OLLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
456 C ST, BLAINE, WA 98230-4238
(360) 332-8733
Mailing address
6045 SUNSHINE DR, FERNDALE, WA 98248-9234
(941) 468-8860
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160807192
WA
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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