Provider Demographics
NPI:1346244043
Name:OLSON, JOLANTA SZEWCZYK (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOLANTA
Middle Name:SZEWCZYK
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 33RD ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-2776
Mailing Address - Country:US
Mailing Address - Phone:360-992-1158
Mailing Address - Fax:360-992-1159
Practice Address - Street 1:100 E 33RD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2776
Practice Address - Country:US
Practice Address - Phone:360-992-1158
Practice Address - Fax:360-992-1159
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032800207R00000X
ORMD156894207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8182388Medicaid
WAG000680512Medicare PIN
WAF62263Medicare UPIN