Provider Demographics
NPI:1770768889
Name:OLSON, ANGELA D (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:D
Last Name:OLSON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4627 156TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4720
Mailing Address - Country:US
Mailing Address - Phone:425-345-3035
Mailing Address - Fax:
Practice Address - Street 1:20102 CEDAR VALLEY RD STE 204
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6333
Practice Address - Country:US
Practice Address - Phone:425-338-7589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00011149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health