Provider Demographics
NPI:1295028025
Name:OLANDER, ELISABETH JOY (LMP)
Entity Type:Individual
Prefix:MISS
First Name:ELISABETH
Middle Name:JOY
Last Name:OLANDER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1008 BETHEL AVE SE
Mailing Address - Street 2:SUITE A WEST SOUND CHIROPRACTIC
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-4235
Mailing Address - Country:US
Mailing Address - Phone:360-895-7744
Mailing Address - Fax:360-895-1166
Practice Address - Street 1:1008 BETHEL AVE SE
Practice Address - Street 2:SUITE A WEST SOUND CHIROPRACTIC
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4235
Practice Address - Country:US
Practice Address - Phone:360-895-7744
Practice Address - Fax:360-895-1166
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024238225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00024238OtherN/A