Healthcare Provider Details

I. General information

NPI: 1689503609
Provider Name (Legal Business Name): KATHRINE A OLSON DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FAIRVIEW AVE N
SEATTLE WA
98109-5369
US

IV. Provider business mailing address

23206 E RIVERSIDE AVE
LIBERTY LAKE WA
99019-9411
US

V. Phone/Fax

Practice location:
  • Phone: 509-998-0682
  • Fax:
Mailing address:
  • Phone: 509-998-0682
  • Fax: 999-999-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRINE A OLSON
Title or Position: OWNER
Credential: DDS
Phone: 509-998-0682