Provider Demographics
NPI:1417457052
Name:OLSON, CATHY B
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:B
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8835 SW CANYON LN STE 125
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3451
Mailing Address - Country:US
Mailing Address - Phone:503-894-6004
Mailing Address - Fax:503-894-6007
Practice Address - Street 1:8835 SW CANYON LN STE 125
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3451
Practice Address - Country:US
Practice Address - Phone:503-894-6004
Practice Address - Fax:503-894-6007
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator