Provider Demographics
NPI:1134568934
Name:OLSEN, DEBBIE R (RPH)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:R
Last Name:OLSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 E 58TH CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7240
Mailing Address - Country:US
Mailing Address - Phone:800-532-0536
Mailing Address - Fax:
Practice Address - Street 1:3411 E 58TH CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7240
Practice Address - Country:US
Practice Address - Phone:800-532-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00054807183500000X
MT3306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist