Provider Demographics
NPI:1841575909
Name:OLSON, SCOTT CURTIS
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:CURTIS
Last Name:OLSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1742 COVEY RUN DR APT B
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2064
Mailing Address - Country:US
Mailing Address - Phone:252-944-5656
Mailing Address - Fax:
Practice Address - Street 1:1742 COVEY RUN DR APT B
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2064
Practice Address - Country:US
Practice Address - Phone:252-944-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program