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General NPI Number Information
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NPI Number | 1386094407
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Entity Type | Individual
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Provider Name | JESSICA OLSTAD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 8719 S 113TH ST APT 101
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City | SEATTLE
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State | WA
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Zip | 98178-3300
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Country | US
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Telephone | 206-556-7610
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Fax |
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Provider Business Mailing Address
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Address Line | 8719 S 113TH ST APT 101
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City | SEATTLE
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State | WA
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Zip | 98178-3300
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Country | US
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Telephone | 206-556-7610
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | CO60275619
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61349551
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License Number State | WA
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