Individual
ELLEN T. OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 N CENTRAL AVE, 1600, PHOENIX, AZ 85004-4527
(602) 744-4765
(602) 744-4799
Mailing address
1850 N CENTRAL AVE, 1600, PHOENIX, AZ 85004-4527
(602) 744-4765
(602) 744-4799
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
40418
AZ
207L00000X
Anesthesiology Physician
MD00040224
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD00040224
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360623
—
AZ
05
—
8317463
—
WA
01
—
P00842063
MEDICARE RAILROAD
—
Enumeration date
06/03/2006
Last updated
10/27/2010
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