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NPI Code Detail

MEDICARE: KATE OLSEN PHARMD

MEDICARE: KATE OLSEN PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPH60216266WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PH60216266OTHERWAPHARMACIST LICENSE

General Provider Information

NPI Number : 1194063776
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATE OLSEN PHARMD
Provider Business Mailing Address
First Line : 609 SPEYERS RD
Second Line :
City : SELAH
State : WA
Zip : 98942-1050
Country : US
Telephone Number : 509-698-1345
Fax Number : 509-697-2217
Provider Business Practice Location Address
First Line : 609 SPEYERS RD
Second Line :
City : SELAH
State : WA
Zip : 98942-1050
Country : US
Telephone Number : 509-698-1345
Fax Number : 509-697-2217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2013
Last Update Date : 12/11/2014

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