Provider Demographics
NPI:1386985885
Name:OLSEN, JAMES PHILLIP (JD, PHD LMHC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIP
Last Name:OLSEN
Suffix:
Gender:M
Credentials:JD, PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 130TH AVE NE STE 104
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1770
Mailing Address - Country:US
Mailing Address - Phone:425-628-2820
Mailing Address - Fax:
Practice Address - Street 1:2370 130TH AVE NE STE F
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1770
Practice Address - Country:US
Practice Address - Phone:425-628-2820
Practice Address - Fax:425-637-1289
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60450953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health