Healthcare Provider Details

I. General information

NPI: 1477466274
Provider Name (Legal Business Name): HEATHER OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

IV. Provider business mailing address

699 WALNUT ST
ASHLAND OR
97520-1583
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number202112728
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: