Provider Demographics
NPI:1659112167
Name:STRIGGOW, OLIVIA ROSE (CN, MS IFN)
Entity type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:ROSE
Last Name:STRIGGOW
Suffix:
Gender:F
Credentials:CN, MS IFN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-8587
Mailing Address - Country:US
Mailing Address - Phone:360-961-3810
Mailing Address - Fax:
Practice Address - Street 1:886 N PARK ST
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-8587
Practice Address - Country:US
Practice Address - Phone:360-961-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU61515778133NN1002X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education