MEDICARE: JOHN C OLSON 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	207Q00000X	Family Medicine Physician	MD00039345	WA
2	208D00000X	General Practice Physician	MD00039345	WA
3	207QA0401X	Addiction Medicine (Family Medicine) Physician	MD00039345	WA

General Provider Information

NPI Number	:	1679512487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C OLSON MD

Provider Business Mailing Address
First Line	:	6400 SOUTHCENTER BLVD
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-2547
Country	:	US
Telephone Number	:	206-901-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 E OLIVE ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-2735
Country	:	US
Telephone Number	:	206-901-2000
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	02/06/2025

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