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General NPI Number Information
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NPI Number | 1477506061
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Entity Type | Organization
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Legal Business Name | SEQUIM MEDICAL ASSOCIATES, PLLP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 840 N 5TH AVENUE SUITE 2100
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City | SEQUIM
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State | WA
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Zip | 98382
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Country | US
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Telephone | 360-582-2850
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Fax | 360-582-2850
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Provider Business Mailing Address
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Address Line | 840 N 5TH AVENUE SUITE 2100
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City | SEQUIM
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State | WA
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Zip | 98382
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Country | US
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Telephone | 360-582-2850
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Fax | 360-582-2851
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Authorized Official
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Title or Position | PARTNER
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Name | ROGER D OLSEN
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Credential | MD
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Telephone | 360-582-2850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00019693
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00041946
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00019647
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00019156
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License Number State | WA
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