Provider Demographics
NPI:1366404675
Name:OLSEN, PATRICK D (ATC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:D
Last Name:OLSEN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 SE SKYHAWK LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-8212
Mailing Address - Country:US
Mailing Address - Phone:360-874-5769
Mailing Address - Fax:
Practice Address - Street 1:425 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4114
Practice Address - Country:US
Practice Address - Phone:360-874-5769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer