Provider Demographics
NPI:1013331065
Name:OLSEN, BRET MARKUS (CADC I)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:MARKUS
Last Name:OLSEN
Suffix:
Gender:M
Credentials:CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 SW COMMERCE CIR STE 312
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-8858
Mailing Address - Country:US
Mailing Address - Phone:503-682-7744
Mailing Address - Fax:503-682-3384
Practice Address - Street 1:9450 SW COMMERCE CIR
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-8855
Practice Address - Country:US
Practice Address - Phone:503-682-7744
Practice Address - Fax:503-682-3384
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13-12-32101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)