Provider Demographics
NPI:1992863252
Name:JAREN, OLAV R (MD)
Entity Type:Individual
Prefix:DR
First Name:OLAV
Middle Name:R
Last Name:JAREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:MS 315010
Mailing Address - Street 2:PO BOX 3947
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124
Mailing Address - Country:US
Mailing Address - Phone:425-635-6731
Mailing Address - Fax:
Practice Address - Street 1:1135 116TH AVE NE
Practice Address - Street 2:STE 500
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-709-7055
Practice Address - Fax:425-709-7066
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA975042084N0400X
WAMD605697402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2047563Medicaid