Provider Demographics
NPI:1467077008
Name:OLSON, JENNIFER (URM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:URM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13921 MERIDIAN E STE 101
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5605
Mailing Address - Country:US
Mailing Address - Phone:253-770-4720
Mailing Address - Fax:253-770-4721
Practice Address - Street 1:13921 MERIDIAN E STE 101
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5605
Practice Address - Country:US
Practice Address - Phone:253-770-4720
Practice Address - Fax:253-770-4721
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No171M00000XOther Service ProvidersCase Manager/Care Coordinator