Active NPI
Adrian Olson
- General Practice Dentistry
- Port Townsend, WA
National Provider Identifier
1306368170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60760031
- Practice address
- 642 Harrison St
Port Townsend, WA 98368-6518 - Phone
- (360) 385-4700
- NPI assigned
- Jul 12, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60760031 | WA | Primary |
Addresses
Primary practice location
642 Harrison St
Port Townsend, WA 98368-6518
Mailing address
642 Harrison St
Port Townsend, WA 98368-6518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171107003234 | WA | Order and Referring Only - Dentist | 4688930670 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60760031 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499817600000",
"number": "1306368170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 HARRISON ST",
"city": "PORT TOWNSEND",
"state": "WA",
"postal_code": "983686518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 HARRISON ST",
"city": "PORT TOWNSEND",
"state": "WA",
"postal_code": "983686518",
"telephone_number": "360-385-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "ADRIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-12",
"last_updated": "2017-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60760031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Townsend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.