MEDICARE: DR. JOHN CHRISTIAN OLSEN D.C.

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	111N00000X	Chiropractor	CH60147006	WA

General Provider Information

NPI Number	:	1255474144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHRISTIAN OLSEN D.C.

Provider Business Mailing Address
First Line	:	4034 W. VAN GIESEN STREET
Second Line	:	SUITE E
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353
Country	:	US
Telephone Number	:	509-967-5500
Fax Number	:	509-967-5501

Provider Business Practice Location Address
First Line	:	4034 W. VAN GIESEN STREET
Second Line	:	SUITE E
City	:	WEST RICHLAND
State	:	WA
Zip	:	99353
Country	:	US
Telephone Number	:	509-967-5500
Fax Number	:	509-967-5501

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	09/30/2013

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