Individual
MRS. SALLY ANN OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
502 2ND AVE NE, PUYALLUP, WA 98372-5001
(253) 312-8044
Mailing address
12702 148TH ST E, PUYALLUP, WA 98374-9485
(253) 312-8044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00008139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81819
LABOR & INDUSTRIES
WA
Enumeration date
06/09/2007
Last updated
07/08/2007
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