Individual
JUSTIN OLSWANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1592
Mailing address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1592
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
OP60093051
WA
390200000X
Student in an Organized Health Care Education/Training Program
TL-2214
CO
Other
Enumeration date
01/26/2007
Last updated
09/15/2020
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