Healthcare Provider Details

I. General information

NPI: 1710338041
Provider Name (Legal Business Name): ARICA RAE OLSON LAC, LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N SEQUIM AVE STE A
SEQUIM WA
98382-3457
US

IV. Provider business mailing address

224 VIEW RIDGE DR
PORT ANGELES WA
98362-9580
US

V. Phone/Fax

Practice location:
  • Phone: 206-445-3671
  • Fax:
Mailing address:
  • Phone: 206-445-3671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60610979
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60611542
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: