Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0800X | Contact Lens | DO00001678 | WA |
NPI | 1851401897 |
---|---|
Provider Name | Sharlet G Olsen |
First Address | Vancouver, WA 98684-6055 |
Second Address | Vancouver, WA 98684-6055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 13/07/2007 |