MEDICARE: DR. STEVEN J OLSON DDS

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	1223G0001X	General Practice Dentistry	6270	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	:	1427009984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J OLSON DDS

Provider Business Mailing Address
First Line	:	136 SW NORMANDY RD
Second Line	:
City	:	NORMANDY PARK
State	:	WA
Zip	:	98166-3902
Country	:	US
Telephone Number	:	206-244-3921
Fax Number	:	206-242-4767

Provider Business Practice Location Address
First Line	:	136 SW NORMANDY RD
Second Line	:
City	:	NORMANDY PARK
State	:	WA
Zip	:	98166-3902
Country	:	US
Telephone Number	:	206-244-3921
Fax Number	:	206-242-4767

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/09/2007

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