| Doctor Name: | OLIVER VON BIRKENWALDAU |
| NPI Number: | 1013116193 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCSW - 992649 |
| Business Practice Address: | 13 1/2 E Main St Suite 214 Walla Walla, WA - 993621950 |
| Business Phone Number: | 5095251750 |
| Business Fax Number: | 5095251606 |
| Mailing Address: | 13 1/2 E Main St, Suite 214 WALLA WALLA |
| State: | WA |
| Postal Code: | 993621950 |
| Phone Number: | 5095251750 |
| Fax Number: | 5095251606 |
| NPI Enumeration Date: | 07/17/2007 |
| NPI Last Update Date: | 07/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW - 992649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |