Healthcare Provider Details

I. General information

NPI: 1295957421
Provider Name (Legal Business Name): CHRISTINE E. OLSON L.AC., DIPL. AC.,LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 NE HIGHWAY 99 SUITE 4
VANCOUVER WA
98665-8747
US

IV. Provider business mailing address

PO BOX 971
WOODLAND WA
98674-1000
US

V. Phone/Fax

Practice location:
  • Phone: 360-695-6055
  • Fax: 360-695-1043
Mailing address:
  • Phone: 360-521-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00018309
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00003033
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: