Provider Demographics
NPI:1386952810
Name:OLSON, AMANDA LORENE (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LORENE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-0605
Mailing Address - Country:US
Mailing Address - Phone:360-695-1325
Mailing Address - Fax:
Practice Address - Street 1:309 W 12TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2903
Practice Address - Country:US
Practice Address - Phone:360-695-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health