Provider Demographics
NPI:1154130169
Name:FREEMAN, OLIVIA ANN (LMT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-5421
Mailing Address - Country:US
Mailing Address - Phone:509-724-0810
Mailing Address - Fax:
Practice Address - Street 1:15 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1109
Practice Address - Country:US
Practice Address - Phone:509-724-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA63170017225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist