Provider Demographics
NPI:1730812629
Name:SLOSSON, OLIVIA (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SLOSSON
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:HOQUIAM
Mailing Address - State:WA
Mailing Address - Zip Code:98550-3027
Mailing Address - Country:US
Mailing Address - Phone:360-533-5531
Mailing Address - Fax:360-538-9819
Practice Address - Street 1:3130 SIMPSON AVE
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-3027
Practice Address - Country:US
Practice Address - Phone:360-533-5531
Practice Address - Fax:360-538-9819
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00057208183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician