MEDICARE: DR. ADAM RICHARD OLSSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	A101269	CA
2	207L00000X	Anesthesiology Physician	MD60321448	WA
3	208VP0000X	Pain Medicine Physician	MD60321448	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073701173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM RICHARD OLSSON MD

Provider Business Mailing Address
First Line	:	101 MED TECH PKWY STE 200
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-4001
Country	:	US
Telephone Number	:	423-232-6120
Fax Number	:	833-450-6025

Provider Business Practice Location Address
First Line	:	11311 BRIDGEPORT WAY SW STE 309
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3078
Country	:	US
Telephone Number	:	253-985-2949
Fax Number	:	253-274-7994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	12/16/2025

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