Provider Demographics
NPI:1659528842
Name:OLSON, KRISTIN ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:ANNE
Last Name:OLSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW GILMAN BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5349
Mailing Address - Country:US
Mailing Address - Phone:425-553-4857
Mailing Address - Fax:
Practice Address - Street 1:1700 NW GILMAN BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5349
Practice Address - Country:US
Practice Address - Phone:425-553-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24092103TC0700X
WA60712183103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical