Healthcare Provider Details

I. General information

NPI: 1760905483
Provider Name (Legal Business Name): OLIN MARTIN ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 SUMMIT AVE
SEATTLE WA
98101
US

IV. Provider business mailing address

1116 SUMMIT AVE
SEATTLE WA
98101-2831
US

V. Phone/Fax

Practice location:
  • Phone: 206-726-4100
  • Fax:
Mailing address:
  • Phone: 206-726-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN60669295
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60884566
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: