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 |
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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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