Individual
DR. SHAYNE C OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2200 S 75TH AVE, PHOENIX, AZ 85043-7410
(623) 907-7349
(623) 936-1490
Mailing address
2200 S 75TH AVE, PHOENIX, AZ 85043-7410
(623) 907-7349
(623) 936-1490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AZ005169
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114849649
—
MI
Enumeration date
03/07/2007
Last updated
02/28/2011
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