Provider Demographics
NPI:1710338041
Name:OLSON, ARICA RAE (LAC, LMP)
Entity Type:Individual
Prefix:
First Name:ARICA
Middle Name:RAE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 VIEW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-9580
Mailing Address - Country:US
Mailing Address - Phone:206-445-3671
Mailing Address - Fax:
Practice Address - Street 1:321 N SEQUIM AVE STE A
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3457
Practice Address - Country:US
Practice Address - Phone:206-445-3671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60610979225700000X
WAAC60611542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist