Individual provider Active NPI

Bethany L Olsen

  • School Registered Nurse
  • Clarkston, WA
National Provider Identifier
1215730775
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN61410468 Issued in WA
Practice address
1587 Sycamore St
Clarkston, WA 99403-1158
Phone
(509) 758-9335
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN61410468 WA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN61410468 WA

Addresses

Primary practice location

1587 Sycamore St
Clarkston, WA 99403-1158

Mailing address

2442 Legacy CT
Clarkston, WA 99403-4501
Phone (208) 790-2687

Other practice location 1

314 1st Street
Asotin, WA 99402
Phone (509) 243-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN61410468WAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1215730775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 LEGACY CT",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994034501",
            "telephone_number": "208-790-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 SYCAMORE ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031158",
            "telephone_number": "509-758-9335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 1st Street",
            "address_purpose": "LOCATION",
            "city": "Asotin",
            "state": "WA",
            "postal_code": "99402",
            "country_code": "US",
            "telephone_number": "509-243-1100",
            "fax_number": "509-243-7720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "BETHANY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN61410468",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN61410468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.