Provider Demographics
NPI:1952596421
Name:OLSON, TONYA KAREN (MPT)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:KAREN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S GARDEN WAY, STE. 250
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8175
Mailing Address - Country:US
Mailing Address - Phone:541-338-7088
Mailing Address - Fax:541-345-3559
Practice Address - Street 1:360 S GARDEN WAY STE 250
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8175
Practice Address - Country:US
Practice Address - Phone:541-338-7088
Practice Address - Fax:541-345-3559
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5506225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR523039021OtherREGENCE BLUE CROSS