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General NPI Number Information
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NPI Number | 1013024041
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Entity Type | Individual
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Provider Name | JOHN CHARLES OLSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 910 18TH AVE EAST
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City | SEATTLE
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State | WA
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Zip | 98112-3930
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Country | US
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Telephone | 206-623-1106
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Fax | 206-329-8915
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Provider Business Mailing Address
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Address Line | 910 18TH AVE E
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City | SEATTLE
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State | WA
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Zip | 98112-3930
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Country | US
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Telephone | 206-623-1106
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Fax | 206-329-8010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD00014882
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License Number State | WA
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