Individual
DR. ROBERT O OLSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13535 SW 72ND AVE STE 170, PORTLAND, OR 97223-8074
(971) 300-0654
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD28601
OR
2084P0800X
Psychiatry Physician
2004-0270
NM
2084P0800X
Psychiatry Physician
DR.0068847
CO
2084P0800X
Psychiatry Physician
Primary
MD28601
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201047052
PRES HEALTH PLAN
NM
05
—
270948
—
OR
05
—
500628018
—
OR
05
—
57936757
—
NM
01
—
85-0105601
ADMAR, BEECH ST AND OTHER
NM
01
—
975076
PRO-NET AETNA
NM
01
—
P00265595
PHCS
NM
01
—
QMYPR00689
MOLINA
NM
Enumeration date
03/01/2007
Last updated
10/21/2024
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