Healthcare Provider Details

I. General information

NPI: 1346244043
Provider Name (Legal Business Name): JOLANTA SZEWCZYK OLSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E 33RD ST SUITE 206
VANCOUVER WA
98663-2776
US

IV. Provider business mailing address

100 E 33RD ST SUITE 206
VANCOUVER WA
98663-2776
US

V. Phone/Fax

Practice location:
  • Phone: 360-992-1158
  • Fax: 360-992-1159
Mailing address:
  • Phone: 360-992-1158
  • Fax: 360-992-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00032800
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD156894
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD156894
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: