| Michael L. Olson Phd Inc Ps | |
|
5108 196th St Sw Ste 208 Lynnwood WA 98036-6152 | |
| (206) 387-7100 | |
| (425) 670-6578 |
| Full Name | Michael L. Olson Phd Inc Ps |
|---|---|
| Speciality | Psychologist |
| Location | 5108 196th St Sw Ste 208, Lynnwood, Washington |
| Authorized Official Name and Position | Michael L Olson (PRESIDENT) |
| Authorized Official Contact | 2063877100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael L. Olson Phd Inc Ps 5108 196th St Sw Ste 208 Lynnwood WA 98036-6152 Ph: (206) 387-7100 | Michael L. Olson Phd Inc Ps 5108 196th St Sw Ste 208 Lynnwood WA 98036-6152 Ph: (206) 387-7100 |
| NPI Number | 1639376627 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 2668568809 |
|---|---|
| Medicare Enrollment ID | O20071102000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639376627 | NPI | - | NPPES |
| 7139405 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1263 (Washington) | Primary |
| Provider Name | Michael L Olson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306919287 PECOS PAC ID: 2264527001 Enrollment ID: I20071009000231 |
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