Provider Demographics
NPI:1861379984
Name:OLSEN, AVARIE (RDN)
Entity type:Individual
Prefix:
First Name:AVARIE
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 S 2275 W
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-5470
Mailing Address - Country:US
Mailing Address - Phone:208-201-3892
Mailing Address - Fax:
Practice Address - Street 1:793 S 2275 W
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-5470
Practice Address - Country:US
Practice Address - Phone:208-201-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered