Provider Demographics
NPI:1386944585
Name:OLSON, BRITTANY MACHELLE (DPT)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:MACHELLE
Last Name:OLSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:MACHELLE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10505 19TH AVE SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4280
Mailing Address - Country:US
Mailing Address - Phone:408-570-0510
Mailing Address - Fax:408-945-4018
Practice Address - Street 1:3710 168TH ST NE
Practice Address - Street 2:#A102
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8461
Practice Address - Country:US
Practice Address - Phone:360-658-8100
Practice Address - Fax:360-658-0508
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60169475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8895445OtherMEDICARE