Provider Demographics
NPI:1730504366
Name:OLSEN, ALYSSA (BA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 CHINOOK AVE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-3747
Mailing Address - Country:US
Mailing Address - Phone:253-335-1765
Mailing Address - Fax:360-802-9377
Practice Address - Street 1:247 CHINOOK AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3747
Practice Address - Country:US
Practice Address - Phone:253-335-1765
Practice Address - Fax:360-802-9377
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula