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General NPI Number Information
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NPI Number | 1457580623
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Entity Type | Organization
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Legal Business Name | DONALD R OLSON, MD, FACS, LLC
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 6464 SW BORLAND RD SUITE A2
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City | TUALATIN
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State | OR
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Zip | 97062-8876
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Country | US
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Telephone | 503-885-1188
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Fax | 503-885-1180
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Provider Business Mailing Address
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Address Line | 6464 SW BORLAND RD SUITE A2
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City | TUALATIN
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State | OR
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Zip | 97062-8876
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Country | US
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Telephone | 503-885-1188
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Fax | 503-885-1180
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BETH ANN PAINERT
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Credential |
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Telephone | 503-885-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD14697
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License Number State | OR
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