Healthcare Provider Details

I. General information

NPI: 1376592824
Provider Name (Legal Business Name): LARAYNE OLSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LARAYNE OLSON ARNP

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2134 STONEY BEACH LN
OAK HARBOR WA
98277-8691
US

IV. Provider business mailing address

2134 STONEY BEACH LN
OAK HARBOR WA
98277-8691
US

V. Phone/Fax

Practice location:
  • Phone: 206-914-0870
  • Fax:
Mailing address:
  • Phone: 206-914-0870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30004454
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00113255
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: