Provider Demographics
NPI:1184016487
Name:OLSON, KATIE DIANE (BS, DC)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:DIANE
Last Name:OLSON
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:DIANE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS,DC
Mailing Address - Street 1:22 BATTERY ST STE 505
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5518
Mailing Address - Country:US
Mailing Address - Phone:415-762-8141
Mailing Address - Fax:
Practice Address - Street 1:22 BATTERY ST STE 505
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5518
Practice Address - Country:US
Practice Address - Phone:415-762-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor