Healthcare Provider Details

I. General information

NPI: 1750388559
Provider Name (Legal Business Name): JACQUELINE S OSLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JACKIE OSLAND MD

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 WYATT WAY NE STE 102
BAINBRIDGE ISLAND WA
98110-2873
US

IV. Provider business mailing address

7254 MADRONA DR NE
BAINBRIDGE ISLAND WA
98110-1902
US

V. Phone/Fax

Practice location:
  • Phone: 206-488-1222
  • Fax: 206-826-1995
Mailing address:
  • Phone: 206-488-1222
  • Fax: 206-826-1995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number60650955
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: