Provider Demographics
NPI:1528702370
Name:OLIVARES TAPIA DE SAIZ, ANA YANET (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:YANET
Last Name:OLIVARES TAPIA DE SAIZ
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:YANET
Other - Middle Name:
Other - Last Name:OLIVARES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IBCLC
Mailing Address - Street 1:320 S MONTGOMERY ST APT 326
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5145
Mailing Address - Country:US
Mailing Address - Phone:971-386-3865
Mailing Address - Fax:
Practice Address - Street 1:320 S MONTGOMERY ST APT 326
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5145
Practice Address - Country:US
Practice Address - Phone:971-386-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-30198174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN