Provider Demographics
NPI:1700699717
Name:OLSON, TAYLOR RAINE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAINE
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAKIAH
Other - Middle Name:RAINE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3723 NE 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1302
Mailing Address - Country:US
Mailing Address - Phone:503-250-1204
Mailing Address - Fax:
Practice Address - Street 1:3723 NE 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1302
Practice Address - Country:US
Practice Address - Phone:503-250-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula