Healthcare Provider Details

I. General information

NPI: 1972435030
Provider Name (Legal Business Name): JENNIFER IRENE OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 NW 77TH ST
SEATTLE WA
98117-3017
US

IV. Provider business mailing address

156 NW 77TH ST
SEATTLE WA
98117-3017
US

V. Phone/Fax

Practice location:
  • Phone: 206-427-2589
  • Fax:
Mailing address:
  • Phone: 206-427-2589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: