Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | DR.0056803 | CO |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD60234837 | WA |
NPI | 1053576033 |
---|---|
Provider Name | Dr. Jared Dean Olson |
First Address | Boulder, CO 80301-2709 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 09/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053576033 | (05) | WA |