Provider Demographics
NPI:1376592824
Name:OLSON, LARAYNE (ARNP)
Entity Type:Individual
Prefix:
First Name:LARAYNE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LARAYNE
Other - Middle Name:
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:2134 STONEY BEACH LN
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8691
Mailing Address - Country:US
Mailing Address - Phone:206-914-0870
Mailing Address - Fax:
Practice Address - Street 1:2134 STONEY BEACH LN
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-8691
Practice Address - Country:US
Practice Address - Phone:206-914-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00113255163W00000X
WAAP30004454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9641762Medicaid
WA0183398OtherLABOR & INDUSTRY
WA28642UOtherREGENCE BLUESHIELD
WA9641762Medicaid
WA0183398OtherLABOR & INDUSTRY