=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386944585
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY MACHELLE OLSON DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2010
-----------------------------------------------------
Last Update Date | 06/02/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3710 168TH ST NE #A102
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98223-8461
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-658-8100
-----------------------------------------------------
Fax | 360-658-0508
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10505 19TH AVE SE SUITE B
-----------------------------------------------------
City | EVERETT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98208-4280
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-570-0510
-----------------------------------------------------
Fax | 408-945-4018
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 60169475
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------