MEDICARE: TANNER OLIVER

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	1041C0700X	Clinical Social Worker	CSW.09929693	CO

General Provider Information

NPI Number	:	1477142081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANNER OLIVER

Provider Business Mailing Address
First Line	:	5300 DTC PKWY STE 450
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-3027
Country	:	US
Telephone Number	:	720-390-6932
Fax Number	:

Provider Business Practice Location Address
First Line	:	6075 S QUEBEC ST STE 200
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-4535
Country	:	US
Telephone Number	:	720-390-6932
Fax Number	:

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

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	12/10/2025

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Directions to “ TANNER OLIVER ” Practice Location

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