Marina V Olsen, MSC, CDP, NCAC

Individual provider Active NPI Professional Counselor · Onalaska, WA

NPI 1518158922 · NPPES record last updated Dec 7, 2012

Key facts

NPI
1518158922
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
CG 60288871 (WA)
Practice address
136 Rice LN
Onalaska, WA 98570-9704
Phone
(360) 269-1266
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CP00000167WAMDAddiction (Substance Use Disorder) Counselor
CG 60288871WAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00000167 WA
Professional Counselor 101YP2500X CG 60288871 WA Yes

Addresses

Primary practice location

136 Rice LN
Onalaska, WA 98570-9704

Mailing address

136 Rice LN
Onalaska, WA 98570-9704
Phone (360) 978-6989

Other providers in Onalaska, WA

All providers in Onalaska, WA · Professional Counselor in Washington

Sources for this page

Verify at the official NPI Registry.