Healthcare Provider Details

I. General information

NPI: 1811234115
Provider Name (Legal Business Name): ELLEN OLSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E INDIANA AVE
SPOKANE WA
99207-2313
US

IV. Provider business mailing address

3901 W COURT ST
PASCO WA
99301-2776
US

V. Phone/Fax

Practice location:
  • Phone: 866-904-7721
  • Fax:
Mailing address:
  • Phone: 866-904-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN001532
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP60693817
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60693817
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: