Individual
MR. CLINTON JERROD OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
1346 12TH ST, CLARKSTON, WA 99403
(509) 758-7805
(509) 751-1510
Mailing address
1346 12TH ST, CLARKSTON, WA 99403
(509) 758-7805
(509) 751-1510
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000046
WA
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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