Provider Demographics
NPI:1700176047
Name:OLSON, ERICK JOSEPH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:JOSEPH
Last Name:OLSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3219
Mailing Address - Country:US
Mailing Address - Phone:509-838-3508
Mailing Address - Fax:509-838-2205
Practice Address - Street 1:810 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3219
Practice Address - Country:US
Practice Address - Phone:509-838-3508
Practice Address - Fax:509-838-2205
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00071959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist