Healthcare Provider Details

I. General information

NPI: 1720741804
Provider Name (Legal Business Name): STEVEN WILLIAM OLSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S COOLIDGE ST
MOSES LAKE WA
98837-1873
US

IV. Provider business mailing address

9643 SE SHORELAND DR
BELLEVUE WA
98004-6512
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-0674
  • Fax:
Mailing address:
  • Phone: 206-510-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD11473
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00007734
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: