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General NPI Number Information
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NPI Number | 1730374091
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Entity Type | Individual
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Provider Name | MR. JASON OSBORNE OLSSON
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Gender | Male
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 5165 11TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-3231
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Country | US
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Telephone | 703-933-0297
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Fax |
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Provider Business Mailing Address
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Address Line | 5165 11TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-3231
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Country | US
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Telephone | 703-933-0297
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT980
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119002941
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 05474
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License Number State | MD
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