Provider Demographics
NPI:1730998436
Name:PROKAZOVA, OLGA
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:PROKAZOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 100TH AVE NE APT 4
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6563
Mailing Address - Country:US
Mailing Address - Phone:206-227-9957
Mailing Address - Fax:
Practice Address - Street 1:11701 100TH AVE NE APT 4
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6563
Practice Address - Country:US
Practice Address - Phone:206-227-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter