Healthcare Provider Details

I. General information

NPI: 1437186897
Provider Name (Legal Business Name): JUDITH OYAMA OLSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 UHRMANN RD STE B
KLAMATH FALLS OR
97601-1174
US

IV. Provider business mailing address

2680 UHRMANN RD STE B
KLAMATH FALLS OR
97601-1174
US

V. Phone/Fax

Practice location:
  • Phone: 541-882-8823
  • Fax:
Mailing address:
  • Phone: 541-882-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number091000232N1
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: