Provider Demographics
NPI:1891189544
Name:OLSEN, MICHELLE RAMOS (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAMOS
Last Name:OLSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21639 104TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2593
Mailing Address - Country:US
Mailing Address - Phone:210-483-0700
Mailing Address - Fax:
Practice Address - Street 1:621 FALLBROOK LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5539
Practice Address - Country:US
Practice Address - Phone:210-483-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant