Healthcare Provider Details

I. General information

NPI: 1376921056
Provider Name (Legal Business Name): JESSICA OLSON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S ARTHUR ST STE 425
SPOKANE WA
99202-2266
US

IV. Provider business mailing address

140 S ARTHUR ST STE 425
SPOKANE WA
99202-2266
US

V. Phone/Fax

Practice location:
  • Phone: 509-294-2987
  • Fax: 206-260-1357
Mailing address:
  • Phone: 509-294-2987
  • Fax: 206-260-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1376921056
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60383814
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: