Individual
JEFF N OLSGAARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, MDIV, NCC, LCPC
Contact information
Practice address
1700 NW CIVIC DR, SUITE 310, GRESHAM, OR 97030-3770
(503) 666-8832
(503) 669-8641
Mailing address
PO BOX 13765, PORTLAND, OR 97213-0765
(971) 266-0536
(888) 875-7309
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
867 - LCPC
MT
101YP2500X
Professional Counselor
Primary
LPC C3060
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12168943
COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE (CAQH)
—
01
—
1881723948
NATIONAL PROVIDER IDENTIF
—
05
—
252790
—
MT
01
—
740233
BLUECROSS BLUESHIELD
MT
Enumeration date
03/05/2007
Last updated
05/27/2013
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