MEDICARE: GEORGE C OLSON M.A., L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C2483	OR

General Provider Information

NPI Number	:	1558681262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE C OLSON M.A., L.P.C.

Provider Business Mailing Address
First Line	:	2001 COMMERCIAL ST SE STE 200
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-5207
Country	:	US
Telephone Number	:	503-949-5941
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 COMMERCIAL ST SE STE 200
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-5207
Country	:	US
Telephone Number	:	503-949-5941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	02/17/2024

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