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NPI Code Detail

MEDICARE: TANNER OLSEN DPM

MEDICARE: TANNER OLSEN DPM
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1831033588
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANNER OLSEN DPM
Provider Business Mailing Address
First Line : 9005 BRIDGEWOOD BLVD UNIT 6206
Second Line :
City : WEST DES MOINES
State : IA
Zip : 50266-8198
Country : US
Telephone Number : 406-407-2928
Fax Number :
Provider Business Practice Location Address
First Line : 4815 N ASSEMBLY ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-6185
Country : US
Telephone Number : 509-434-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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