Provider Demographics
NPI:1982814596
Name:OLSEN, MATTHEW D (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:OLSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SW CAMPUS DR
Mailing Address - Street 2:#5-4
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-5363
Mailing Address - Country:US
Mailing Address - Phone:319-541-7061
Mailing Address - Fax:
Practice Address - Street 1:1300 SW CAMPUS DR
Practice Address - Street 2:#5-4
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-5363
Practice Address - Country:US
Practice Address - Phone:319-541-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR7862207R00000X
CA12383208M00000X
WAOP60084780208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine