Provider Demographics
NPI:1730380791
Name:OLSON, JEFFREY STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:STEPHEN
Last Name:OLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:9900 SE SUNNYSIDE ROAD
Mailing Address - Street 2:KAISER SUNNYBROOK MEDICAL OFFICE
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015
Mailing Address - Country:US
Mailing Address - Phone:503-571-9134
Mailing Address - Fax:503-571-3069
Practice Address - Street 1:9900 SE SUNNYSIDE ROAD
Practice Address - Street 2:KAISER SUNNYBROOK MEDICAL OFFICE
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015
Practice Address - Country:US
Practice Address - Phone:503-571-9134
Practice Address - Fax:503-571-3069
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR25234207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology