Provider Demographics
NPI:1013244599
Name:OLANDER, RANDY (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:OLANDER
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 NW CALKINS AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1800
Mailing Address - Country:US
Mailing Address - Phone:541-680-1231
Mailing Address - Fax:541-680-1231
Practice Address - Street 1:2260 NW CALKINS AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1800
Practice Address - Country:US
Practice Address - Phone:541-680-1231
Practice Address - Fax:541-680-1231
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2748103TC0700X
103TC1900X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling