Individual
SHAWNA T OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
19259 HIGHWAY 36, BLACHLY, OR 97412-9740
(541) 206-3139
Mailing address
19259 HIGHWAY 36, BLACHLY, OR 97412-9740
(541) 206-3139
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BAPE10249209
OR
Other
Enumeration date
07/19/2025
Last updated
07/19/2025
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