Provider Demographics
NPI:1760212534
Name:OLSON, HOLLIE (MICROPIGMENTATION)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MICROPIGMENTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12504 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7855
Mailing Address - Country:US
Mailing Address - Phone:360-521-1953
Mailing Address - Fax:
Practice Address - Street 1:2005 SE 192ND AVE STE 104
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7475
Practice Address - Country:US
Practice Address - Phone:360-210-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1038246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other