Provider Demographics
NPI:1124617642
Name:OLSON, SIENNA (DC)
Entity type:Individual
Prefix:DR
First Name:SIENNA
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SIENNA
Other - Middle Name:
Other - Last Name:STRUTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2634 N GOVERNMENT WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-3750
Mailing Address - Country:US
Mailing Address - Phone:208-664-1000
Mailing Address - Fax:208-664-1001
Practice Address - Street 1:2634 N GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-3750
Practice Address - Country:US
Practice Address - Phone:208-664-1000
Practice Address - Fax:208-664-1001
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-6774111N00000X
ID2133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor