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General NPI Number Information
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NPI Number | 1285908095
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Entity Type | Individual
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Provider Name | MICHAEL S OLSON PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 900 23RD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-2342
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Country | US
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Telephone | 202-715-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 GRACIE PARK DR
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City | HERNDON
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State | VA
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Zip | 20170-6225
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Country | US
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Telephone | 808-354-1939
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110008374
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 52529
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | AMD-449
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA200001329
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License Number State | DC
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