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General NPI Number Information
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NPI Number | 1215219068
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Entity Type | Organization
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Legal Business Name | OLSEN CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 2402 BROADWAY
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City | VANCOUVER
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State | WA
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Zip | 98663
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Country | US
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Telephone | 360-241-6630
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Fax | 360-567-0620
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Provider Business Mailing Address
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Address Line | 2402 BROADWAY
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City | VANCOUVER
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State | WA
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Zip | 98663
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Country | US
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Telephone | 360-241-6630
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Fax | 360-567-0620
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARA OLSEN
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Credential | DC
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Telephone | 360-241-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60320567
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60190315
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60236454
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60239117
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034644
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License Number State | WA
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