Provider Demographics
NPI:1295957421
Name:OLSON, CHRISTINE E (LAC, DIPL AC,LMP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:OLSON
Suffix:
Gender:F
Credentials:LAC, DIPL AC,LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 971
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-1000
Mailing Address - Country:US
Mailing Address - Phone:360-521-6441
Mailing Address - Fax:
Practice Address - Street 1:6202 NE HIGHWAY 99
Practice Address - Street 2:SUITE 4
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8747
Practice Address - Country:US
Practice Address - Phone:360-695-6055
Practice Address - Fax:360-695-1043
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018309172M00000X
WAAC00003033171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
219984OtherL&I