Provider Demographics
NPI:1184727117
Name:OLSON, REBECCA LYNN (ARNP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17191 BOTHELL WAY NE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-5534
Mailing Address - Country:US
Mailing Address - Phone:206-364-8272
Mailing Address - Fax:206-364-5418
Practice Address - Street 1:17191 BOTHELL WAY NE
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKE FOREST PARK
Practice Address - State:WA
Practice Address - Zip Code:98155-5534
Practice Address - Country:US
Practice Address - Phone:206-364-8272
Practice Address - Fax:206-364-5418
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00066043163W00000X
WAAP30000458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9607862Medicaid
WAS19738Medicare UPIN
WA9607862Medicaid