Provider Demographics
NPI:1972811909
Name:OLSON, BRENDA ANN (MD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8329 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-2215
Mailing Address - Country:US
Mailing Address - Phone:503-414-5160
Mailing Address - Fax:
Practice Address - Street 1:8329 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:BUILDING 2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2215
Practice Address - Country:US
Practice Address - Phone:503-414-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD168585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine