Provider Demographics
NPI:1700507530
Name:COURSER, OLIVIA RENEE
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:RENEE
Last Name:COURSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 NE 75TH ST UNIT 329
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6352
Mailing Address - Country:US
Mailing Address - Phone:406-270-4106
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST HEALTH SCIENCES BUILDING ROOM T-301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:065-438-7362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61338844163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163W00000XNursing Service ProvidersRegistered Nurse